000000099999 2021-12-31 000000099999 2022-12-31 000000099999 2021-01-01 2021-12-31 000000099999 2022-01-01 2022-12-31 000000099999 Decrease in Equity in Joint Venture [Typed Member] 2021-01-01 2021-12-31 000000099999 Decrease in Equity in Joint Venture [Typed Member] 2022-01-01 2022-12-31 000000099999 2020-12-31 iso4217:USD
REPORT TO
THE CITY
2022
1
DENVER HEALTH
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REPORT TO THE CITY
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TABLE OF CONTENTS
Letter from the CEO
......................................................................................................................................
3
2022 Year in Review
........................................................................................................................................
6
Denver Health Performance
2022 Denver Health Regulatory Surveys
...........................................................................................................
12
Patient Care Services (A-1)
.........................................................................................................................................
16
Emergency Medical Services (A-2)
.......................................................................................................................
34
Public Health Services (A-3)
.......................................................................................................................................
38
Denver Community Addiction Rehabilitation and Evaluation Services (CARES) (A-4) ..44
Medical Services for Arrestees, Pretrial Detainees and Inmates (A-6)
.......................................
48
Denver Health Medical Plan and City Employee Health Care Opinion Survey (A-7)
........
52
Rocky Mountain Poison and Drug Safety Services (RMPDS) (A-8)
................................................
56
Clinical and Laboratory Services for the City's Department of Public Health &
Environment (A-9)
.............................................................................................................................................................
60
Center for Occupational Safety and Health (COSH) and Worker's Compensation Triage
Line (OUCH Line) (B-1)
....................................................................................................................................................
62
NurseLine Services (B-2)
...............................................................................................................................................
66
Acute and Chronic Health Care at Denver County Jail and Downtown Detention Center
(B-3)
.............................................................................................................................................................................................
70
Miscellaneous Services for DDPHE (B-7)
...........................................................................................................
72
Miscellaneous Services for the Department of Public Safety (B-8)
..............................................
76
Miscellaneous Services, Other (B-9)
.....................................................................................................................
80
Uncompensated Care
...................................................................................................................................
82
Financial Statements
...................................................................................................................................
84
Contract Reconciliation
..............................................................................................................................
88
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01
Letter from
the CEO
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DENVER HEALTH
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DENVER HEALTH
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REPORT TO THE CITY
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Honorable Mayor Michael B. Hancock
City and County of Denver
1437 N. Bannock Street, Room 350
Denver, CO 80202
April 22, 2023
Dear Mayor Hancock,
As Chief Executive Officer of Denver Health, it is an honor to share the 2022 Denver Health and Hospital
Authority’s Compliance with Operating Agreement Performance Report. With Denver Health’s Operating
Agreement as our guide, the information in this report captures the commitment of Denver’s longest-serving
health care institution – an essential partner to the City. The pride of more than 160 years of dedication
to care for the people of Denver and throughout the state is visible in every highlighted area. By working
together with you and your Administration, we are strengthening the health and safety of our community.
Since becoming Denver Health CEO in September 2022, every day I see how valuable the people and
programs of our city’s safety-net hospital are to the health and wellbeing of our residents – and to the city
and state itself. I’ve met incredible health care workers who remained committed during COVID-19, one of
the most trying health care crises in our country. The past three years have strengthened the resolve of so
many at Denver Health to maintain high-quality care for all patients but especially for those experiencing
the worst of the pandemic. Our team is resilient and determined to maintain operational stability to a health
care organization that so many rely on.
As you will see in the following pages, our reach is well beyond the walls of our main hospital. Care at 10
federally qualified community health centers and 19 Denver Health Pediatrics at Denver Public Schools
extends throughout our community. Denver Health is a training location for hundreds of students and
residents each year, many who connect with our mission and return to working here after completing their
education. Our researchers have successfully secured nearly $97 million in research, training and service
awards in 2022 that fund projects that capture our commitment to learning and translating new findings to
improve the care experience nationwide and even throughout the world.
It’s a time of great change for our city and our health care system. This report shows the incredible impact
we have despite our challenges, highlights what’s possible when working on behalf of others, and captures
the powerful relationship and commitment to our agreement with the City and service the people and
community it serves.
Sincerely,
Donna Lynne, DrPH
Chief Executive Officer
Denver Health
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02
2022 Year
in
Review
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A Year In Review
While 2022 provided many
challenges throughout health
care – including ongoing fallout
from the COVID-19 pandemic
and financial hardships for
many health care systems –
Denver Health continued to
provide best-in-class care,
serving the City and County
of Denver and beyond. Our
providers saw more than 1.2
million patients with more than
970,000 patients seen in our
clinics, outside of the hospital.
More patients than ever before
turned to Denver Health to
access mental and oral health
care.
In addition to increases in
patients served, the health care
system made great strides in
new health initiatives and other
exciting achievements. Here is
a selection of that work in 2022.
Denver Health launched
an employee resource group
dedicated to the LGBTQ+
community and allies called
PRISM (Pride Representatives
in Service of Medicine)
. In its
first year, members supported
Pride celebrations, LGBTQ+
History Month and a legislative
statement by Denver Health
on Section 1557 of the Patient
Protection and Affordable
Care Act. PRISM’s mission is
to highlight and celebrate
LGBTQ+ employees by creating,
maintaining and enabling
communication channels
between LGBTQ+ employees,
allies and Denver Health
leadership.
Medical
analytics
publishing
company
Elsevier
placed
Denver Health
surgeon
Ernest E. Moore, MD, among the
top five most-cited surgeon-
scientists in the world
. Dr. Moore,
renown trauma surgeon and
director of trauma research at
Denver Health, is internationally
recognized for his expertise.
Dr. Moore, after whom Denver
Health’s Ernest E. Moore Shock
Trauma Center is named,
continues to advance the study
of trauma care worldwide.
The Colorado Academy of
Family Physicians honored Lowry
Family Health Center with the
Practice Award for Health Equity
& Community Engagement
.
The award highlights practices
in family
medicine
making
progress in
reducing
racial and
other health
disparities.
Of the 17,400 people who receive
care at Lowry, 16 percent speak
Spanish and another 28 percent
speak a language other than
English or Spanish, and many are
refugees.
Denver Health staff joined
George Washington High
School’s principal at
the opening
of our newest, and 19th, school-
based health center
. Denver
Health’s school-based health
centers provides physical and
behavioral health care services
FEBRUARY
to Denver Public Schools students
at no cost. It’s estimated that
the center’s staff at George
Washington will care for more
than 1,200 youth per year.
Denver Health’s
Refugee Clinic
hosted visitors from around the
world
who came to learn how
we screen patients and to take
those ideas back to their own
countries. About 20 people who
lead resettlement efforts in other
nations, including Australia,
Switzerland, Belgium and the
United Kingdom, toured the
Lowry Family Health Center.
Denver Health’s Afghan Refugee
Response Team has screened
more than 1,000 evacuees since
the United States ended military
operations in Afghanistan.
The Pediatric Academic Society
recognized Denver Health’s
Division of General Pediatrics
and School Health with the
2022
Health Care Delivery Award
. The
award recognized multipronged
COVID-19 efforts focused on
students and families in Denver.
At a national conference, the
society highlighted our telehealth
innovations, vaccination
accomplishments and school
partnerships promoting safety in
the pandemic.
The Denver Prevention Training
Center (DPTC), a program of the
Public Health Institute at Denver
Health, secured over
$1.2 Million
in new grant funding
to support
its National Network of STD
MARCH
APRIL
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Clinical Training Center (NNPTC)
and Disease Intervention Training
Center (DITC) efforts.
As part
of these grants, the DPTC has
facilitated and delivered mpox
training. The DPTC also delivered
additional disease intervention
training as part of the American
Rescue Act to address emerging
public health issues.
Denver Health and its public
health clinics began supporting
the mpox response in Denver,
the metro region, and across the
state. Public health providers
emerged as local experts in the
mpox response, supporting other
departments at Denver Health
as well as partners and the
community. Public health clinics
later would begin offering TPOXX
treatment in June under a special
investigational drug protocol,
and Denver Health initially was
the only organization in Colorado
providing the treatment.
Denver Health’s Ambulatory
Care Services Quality
Improvement team
honored
six employees and three
clinics as Quality Heroes
.
The annual awards recognize
primary care providers, medical
assistants and clinics across
Denver Health with the highest
scores in quality improvement
goals, such as screenings for
cervical cancer, controlling
high blood pressure, evaluating
kidney health, following up on
depression and closing gaps in
care. The Westside Pediatrics
clinic, internal medicine at the
Westside Adult clinic, and family
medicine at the Montbello
Family Health Center scored the
highest among Denver Health
clinics.
The Denver Health
Pediatric
Dental Residency Program’s
first class of residents started
in
the Webb building on the main
campus for a two-year program
that, once fully operational, is
expected to increase patient
capacity for pediatric dentistry
to over 2,000 patient visits a
month. In addition, specialty
pediatric dental care allows for
more access to our most at-risk
populations for treatment under
general anesthesia and sedation.
Duane Mata, MD, director of
dentistry for community health,
sees this as the first step in
establishing Denver Health as a
leader in children’s oral health for
not only Denver County but the
entire metro area.
The nonprofit LGBTQ+
advocacy organization
Human
Rights Campaign designated
Denver Health as a leader in
health care equality
. Our health
care system is one of only two
hospitals in Colorado to receive
the 2022 recognition, marked by
our 100-point score – the highest
possible – on the Healthcare
Equality Index. The national
benchmarking tool evaluates
health care facilities’ policies and
practices related to the equity
and inclusion of LGBTQ+ patients,
visitors and employees.
MAY
The
Infectious Diseases (ID)
Clinic within the Public Health
Institute at Denver Health
secured over $500,000 in new
grant funding
to implement a
low-barrier, drop-in subspecialty
clinic for people with HIV.
Modeled after the MAX Clinic in
Seattle, the Direct Access to Care
Environment (DACE) Clinic will
provide nontraditional means
of care access to those with the
most need. Spanning 32 months
of funding, this intervention will
help to achieve and sustain our
organization’s commitment of
advancing health equity while
working to close gaps within
the HIV care continuum. The ID
Clinic was one of three national
sites selected to receive this
grant funding for MAX Clinic
implementation.
Fifty-eight physicians at
Denver Health made the list of
“Top Doctors” in 5280 magazine
.
Featured among 343 doctors in
the Denver metro area’s seven
counties, honorees were voted by
other doctors as the physician
they would most want caring for
themselves and their families.
The
Nurse Residency Program
received accreditation with
distinction
from the American
Nurses
Credentialing
Center (ANCC)
Practice
Transition
Accreditation
Program (PTAP).
The ANCC PTAP
sets the global
standard for nurse residency
programs that transition
graduate nurses into professional
practice. Our program is the only
nurse residency program in the
Denver metro area to achieve the
accreditation.
AUGUST
JUNE
JULY
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Denver Health launched the
Access Transformative Outreach
Program (ATOP) to help patients
with severe substance use
disorders
. ATOP is an intensive,
community-based intervention
program in partnership with
Colorado Access. Most patients
are experiencing homelessness,
have significant medical or
mental health conditions, and
lack family or social support.
Former
Colorado Lt.
Gov.
Donna
Lynne, DrPH,
took over
as CEO
of Denver
Health
,
beginning
another
chapter in our more than 160-
year history. Since her start,
our new CEO has fostered
an unprecedented level
of engagement with staff,
particularly during new CEO
listening sessions in the fall and
winter, receiving and responding
to questions and feedback from
the thousands of employees
who attended those sessions.
“One tenet I live by,” Lynne said,
“is best expressed by Albert
Schweitzer: ‘The purpose of
human life is to serve, and to
show compassion and the will to
help others.’”
Forbes named Denver Health
as one of America’s Best-
in-State Employers of 2022
.
This recognition was created
through a survey of 70,000 U.S.
employees across 25 industry
sectors. The survey considered
every aspect of an employee’s
experience such as working
conditions, salary, diversity and
potential for growth.
Denver Health has the second-
ranked emergency medicine
residency program in the
country
, based on reputation
scores. The ranking by health
care platform Doximity’s
Residency Navigator is based on
more than 300,000 reviews and
ratings from more than 125,000
physicians, including current
residents and recent alumni.
Denver Health is ranked below
only the Los Angeles County and
University of Southern California
Medical Center in Los Angeles.
Rocky Mountain Poison &
Drug Safety participated in the
Denver Fentanyl Action Summit
.
Data from the Researched
Abuse, Diversion and Addiction-
Related Surveillance (RADARS)
initiative were shared to describe
fentanyl use and treatment
opportunities in Denver and to
educate stakeholders to help
address the fentanyl crisis in the
community.
SEPTEMBER
OCTOBER
The
2022 Vizient Quality and
Accountability scorecards
showed Denver Health ranked
in the top 10% in medication
communication and
responsiveness of staff; top 20%
for doctor communication; top
30% for nurse communication,
cleanliness and quietness, and
discharge information; and top
40% for overall hospital rating.
Denver Health’s
At-risk
Intervention and Mentoring
(AIM)
, a hospital-based violence
intervention program that
uses a multidisciplinary, public
health approach to stop the
cycle of violence, performed 353
bedside interventions, reached
1,083 individuals and responded
to 45 crisis situations in the
community, and performed 25
trauma-informed care trainings.
AIM combines its hospital-based
work with partnerships with
numerous community-based
organizations, Denver Public
Schools and the Denver Police
Department, to comprehensively
address social determinants of
health. AIM was awarded $1.4
million in grants from the United
States Department of Justice
and Colorado Department of
Public Safety to expand its
services and perform rigorous
program evaluation.
The
Bariatric Surgery Center
reached 125 cases in a year
for the first time
, up from 102
cases in 2021. This has been the
bariatric surgery team’s goal for
years, and the milestone allows
the center to contract with all
commercial payers.
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Greenhealth for its efforts in 2022.
Denver Health was honored with
the Partner for Change Award
and the Circle of Excellence
Award for Energy
. They follow
2021’s Environmental Excellence
Award, which recognized Denver
Health’s “superior performance in
environmental sustainability.”
Denver Health staff once again
displayed their commitment to
our community and patients
as a multidisciplinary team
mobilized to provide medical
care, assessment, treatment
and vaccinations to a flood of
migrants who unexpectedly
arrived in Denver by bus. In
partnership with the Denver
Department of Public Health and
Environment,
the team deployed
a mobile health center to
emergency shelters
and helped
hundreds of our new neighbors.
The
Infant Mental Health
program at Denver Health
celebrated another year of
having specialists who work with
children at all 10 Denver Health
community health centers. This
innovative program provides a
multigenerational approach to
mental health care, focusing on
both the child and the caregivers.
The goal is to prevent the
emotional, social and financial
costs of adverse childhood
experiences and toxic stress as
the child grows and matures.
DECEMBER
NOVEMBER
The
American College of
Surgeons approved the Bariatric
Surgery Center's accreditation
,
making Denver Health the
only hospital in Denver that
is Metabolic and Bariatric
Surgery Accreditation and
Quality Improvement Program
(MBSAQIP)-certified for both
adolescents and adults. Our
multidisciplinary adolescent
team will began evaluating
referrals for bariatric surgery in
patients aged 15–20 years, with
surgery offered once patients
turn 16. Denver Health continues
to care for adult bariatric
surgery patients aged 21-65.
The
Denver Health High Risk
Infection Team (HITeam) was
recognized by the National
Emerging Special Pathogens
Training and Education Center
for ensuring readiness and
preparedness for the hospital
and staff in safely treating and
caring for patients with highly
infectious diseases. The HITeam is
staffed by a group of physicians,
registered nurses, respiratory
therapists, medical laboratory
scientists, paramedics, and
emergency medical technicians
who are prepared to identify,
isolate, transport, treat and care
for patients.
The
University of Colorado
School of Medicine recognized
several Denver Health faculty as
outstanding educators
, including
Anne Frank, MD (Internal
Medicine Teacher of the Year),
Jessica Jack, MD (Pediatrics
Teacher of the Year), Shalvi Patel,
MD (Family Medicine Teacher
of the Year), Nathan Grohmann,
MD (Surgery Teacher of the
Year), Jennie Buchanan, MD
(Emergency Medicine Teacher of
the Year), Kate Adkins, MD (OB/
GYN Teacher of the Year. The
physicians were chosen among
nominations from students in the
school's longitudinal integrated
clerkship curriculum.
Denver
Health’s
Security
Operations
Center
(SOC) in
Pavilion
J was
activated
and will
become the 24/7 home for
security dispatchers in 2023,
helping to reduce officers’
response times to incidents
on the main campus. The SOC
is the security team’s new
communications hub, which
allows dispatch to communicate
with officers in the field and
with law enforcement while
monitoring scenes in real time.
Denver Health continues
to make great strides in
environmental sustainability, and
the health care system was once
again recognized by Practice
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03
Denver Health
Performance
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Article V
5.1
Annual Report of the Denver Health and Hospital
Authority to the City
The Authority shall deliver a written annual report to
the City within six months of the end of its Fiscal Year,
commencing with Fiscal Year 1998, which report shall
include:
A.
The latest financial statements of the Authority
which have been audited by an independent auditing
firm selected by the Authority.
Response:
Criteria met
The Authority has provided the City with the
appropriate financial statements which have been
audited by an independent auditing firm. The 2022
financial statements are presented in Section 19 of
this report.
B.
An executive summary of the results of all
regulatory and accreditation surveys with respect
to the Authority which have been completed during
such last Fiscal Year.
Response:
Criteria met
A summary of the results of all regulatory and
accreditation surveys with respect to the Authority is
presented in Section 03 of this report.
C.
A report of the disposition of all matters regarding
the Authority that have been referred to the Liaison
by the Mayor or any member of City Council during
such Fiscal Year.
Response:
Criteria met
All matters referred to the Liaison have been
promptly addressed.
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Organization
DH Program/Site or Issue Surveyed
Survey/
Inspection
Date
Term
CDPHE/Mammography Quality Standards Act
Denver Health Mammography and Mobile
Mammography "new" mobile clinic
9/8/2022
1-2 years
Colorado State Board of Pharmacy
Bruce Randolph Middle School, School Based Health
Center
11/16/2022
1-2 years
Colorado State Board of Pharmacy
Denver C.A.R.E.S
7/19/2022
1-2 years
Colorado State Board of Pharmacy
Denver Health Central Fill Pharmacy
11/2/2022
1-2 years
Colorado State Board of Pharmacy
Denver Health Materials Management Warehouse
6/6/2022
1-2 years
Colorado State Board of Pharmacy
Denver Health Medical Center Hospital Pharmacy
6/6/2022
1-2 years
Colorado State Board of Pharmacy
Denver Health Medical Center Hospital Pharmacy
11/22/2022
1-2 years
Colorado State Board of Pharmacy
Denver Health OMC Infusion and Clinics Pharmacy
11/3/2022
1-2 years
Colorado State Board of Pharmacy
Denver Health Outpatient Medical Center Pharmacy
10/18/2022
1-2 years
Colorado State Board of Pharmacy
Denver Health Primary Care Pharmacy
11/2/2022
1-2 years
Colorado State Board of Pharmacy
Denver Health Winter Park Medical Center
6/29/2022
1-2 years
Colorado State Board of Pharmacy
Eastside Family Health Center Teen Clinic
11/16/2022
1-2 years
Colorado State Board of Pharmacy
Eastside Neighborhood Health Center
12/22/2022
1-2 years
Colorado State Board of Pharmacy
Evie Dennis Campus School Based Health Center
12/1/2022
1-2 years
Colorado State Board of Pharmacy
Federico F. Pena Family Health Center
11/4/2022
1-2 years
Colorado State Board of Pharmacy
Florence Crittenton High School
5/12/2022
1-2 years
Colorado State Board of Pharmacy
George Washington High School
11/14/2022
1-2 years
Colorado State Board of Pharmacy
John F. Kennedy High School
9/26/2022
1-2 years
Colorado State Board of Pharmacy
Kepner Middle SBHC
11/14/2022
1-2 years
Colorado State Board of Pharmacy
La Casa-Quigg Newton Health Center Pharmacy
7/1/2022
1-2 years
Colorado State Board of Pharmacy
Lake Middle School
5/31/2022
1-2 years
Colorado State Board of Pharmacy
Lincoln High School Based Health Center
11/29/2022
1-2 years
Colorado State Board of Pharmacy
Lowry Family Health Center Pharmacy
4/7/2022
1-2 years
Colorado State Board of Pharmacy
Manual High school
11/16/2022
1-2 years
Colorado State Board of Pharmacy
Montbello Family Health Center Pharmacy
10/5/2022
1-2 years
Colorado State Board of Pharmacy
North High School
5/31/2022
1-2 years
Colorado State Board of Pharmacy
Park Hill Family Health Center
4/18/2022
1-2 years
Colorado State Board of Pharmacy
Place Bridge Academy Campus
11/14/2022
1-2 years
Colorado State Board of Pharmacy
Rachel Noel Middle School
12/14/2022
1-2 years
Colorado State Board of Pharmacy
South High School Based Health Center
10/5/2022
1-2 years
Colorado State Board of Pharmacy
Thomas Jefferson High School
11/3/2022
1-2 years
Colorado State Board of Pharmacy
Urgent Care at
Federico F Pena Family Health Center
7/26/2022
1-2 years
Colorado State Board of Pharmacy
West High School
12/5/2022
1-2 years
Colorado State Board of Pharmacy
Westside Family Health Center Teen Clinic
7/26/2022
1-2 years
Colorado State Board of Pharmacy
Westside Neighborhood Health Center
11/2/2022
1-2 years
Colorado State Board of Pharmacy
Westwood Family Health Center
7/21/2022
1-2 years
Denver Fire Department
All Central Campus Sites
8/25/2022
1 year
Denver Fire Department
Denver C.A.R.E.S
8/25/2022
1 year
Denver Fire Department
Eastside Family Health Center
6/22/2022
1 year
Denver Fire Department
La Casa-Quigg Newton Health Center
5/24/2022
1 year
DENVER HEALTH REGULATORY SURVEYS 2022
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Organization
DH Program/Site or Issue Surveyed
Survey/
Inspection
Date
Term
DENVER HEALTH REGULATORY SURVEYS 2022
Denver Fire Department
Lowry Family Health Center
4/13/2022
1 year
Denver Fire Department
Montbello Family Health Center
5/16/2022
1 year
Denver Fire Department
Park Hill Family Health Center
5/9/2022
1 year
Denver Fire Department
Pena Family Health Center
5/18/2022
1 year
Denver Fire Department
Rose Andom
10/27/2022
1 year
Denver Fire Department
Westside Family Health Center
6/14/2022
1 year
Denver Fire Department
Westwood Family Health Center
5/12/2022
1 year
The Joint Commission
Hospital Laboratory
3/8/2022
2 years
The Joint Commission
Ambulatory Laboratories
8/2/2022
2 years
Office of Behavioral Health
(Controlled Substance License)
OBHS 667 Bannock Street (Methadone program)
1/27/2022
1 year
Signal Behavioral Health Network
OBHS 667 Bannock Street (Methadone program)
4/27/2022
1 year
Signal Behavioral Health Network
Denver CARES 1155 Cherokee St
5/5/2022
1 year
Vaccines For Children / CDPHE Site Visit
Abraham Lincoln High School
11/2/2022
2 years
Vaccines For Children / CDPHE Site Visit
Bruce Randolph Middle School
11/15/2022
2 years
Vaccines For Children / CDPHE Site Visit
DHMC Inpatient Pediatrics
2/23/2022
2 years
Vaccines For Children / CDPHE Site Visit
East High School
3/17/2022
2 years
Vaccines For Children / CDPHE Site Visit
Eastside Pediatric & Teen Clinic
12/19/2022
2 years
Vaccines For Children / CDPHE Site Visit
George Washington High School
11/15/2022
2 years
Vaccines For Children / CDPHE Site Visit
La Casa Family Health Center
2/23/2022
2 years
Vaccines For Children / CDPHE Site Visit
Lowry Family Health Center
3/11/2022
2 years
Vaccines For Children / CDPHE Site Visit
Manual High school
5/10/2022
2 years
Vaccines For Children / CDPHE Site Visit
Montbello High School
3/8/2022
2 years
Vaccines For Children / CDPHE Site Visit
Montbello Family Health Center
12/1/2022
2 years
Vaccines For Children / CDPHE Site Visit
Park Hill Family Health Center
3/29/2022
2 years
Vaccines For Children / CDPHE Site Visit
Pena Family Health Center
3/8/2022
2 years
Vaccines For Children / CDPHE Site Visit
Thomas Jefferson High School
11/3/2022
2 years
Vaccines For Children / CDPHE Site Visit
Webb Pediatrics
2/15/2022
2 years
Vaccines For Children / CDPHE Site Visit
Westwood Family Health Center
3/11/2022
2 years
Organization
DH Program/Site or Issue Surveyed
Survey/Inspection
Date
Outcome
CDPHE
Pena Clinic
1/18/2022
No findings cited
CDPHE
Acute Care Complaint Survey
5/9/22 - 5/12/22
Condition level finding
CDPHE
Acute Care Complaint Re-Survey
7/6/2022
No additional findings cited
The Joint Commission
Core Lab & OMC Lab (initial survey)
3/8/22 - 3/11/22
Findings with an action plan
The Joint Commission
Pena, ACS clinic labs, and SBC labs survey
8/22/22 - 8/26/22
Findings with an action plan;
no condition levels
DENVER HEALTH UNANNOUNCED REGULATORY VISITS 2022
04
A-1
Patient
Care Services
16
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17
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Appendix A-1 Patient Care Services
1.5
Performance Criteria
A.
The Authority shall submit an annual report to the
City which includes the data indicated below in the
Performance Criteria tables in 1.5(g) and 1.5(h) for the
year just ended, as well as the two previous Fiscal
Years, by May 1 following the reporting year.
Response:
Criteria met
The Authority respectfully submits for consideration
the
2022 Report to the City
dated
April 22, 2023
in
compliance with the 2022 Operating Agreement
performance reporting requirements.
G.
Performance Criteria Table - Clinical
(I-W numbering follows the Authority's annual report).
For all criteria, active patients are defined as
empaneled patients who have had a Primary care
visit in the past 18 months.
For performance criteria without goals or targets, a
trend line is provided.
1.5I
Childhood Immunization Rate
Goal:
At least 75% of patients with at least one
medical visit in the last year who became 24 mos of
age in last year who have received 4 DTap, 3 Polio, 1
MMR, 3 HIB, 3 Hepatitis B, 1 Varicella, 4 Pneumococcal
immunizations, 1 Hepatitis A, and 2 or 3 Rotavirus by
24 mos of age.
Response: Criteria not met.
Variance Explanation:
The primary cause for not achieving the target was
missing the window for first roto vaccine dose for
patients transferring care to Denver Health. In 2023,
Denver Health will work with outside hospitals and
organizations to better coordinate care for patients
to get timely appointments within the roto vaccine
window.
1.5J
Percent Women Entering Prenatal Care
Goal:
At least 70% of women will begin care within the
1st trimester.
Response:
Criteria met
1.5L
Patient Satisfaction
Goal - Ambulatory Care:
The mean composite
patient experience score in primary care will be 90%
or greater.
Response:
Criteria not met
Variance Explanation:
Access issues, primarily due to staffing challenges
and high demand, had the greatest impact on
patient experience scores. Improving access to care
at Denver Health is an organization-wide strategic
priority in 2023
.
Goal - Hospital Care:
78% of hospitalized patients
will respond with a 9 or a 10 (“top box”) for overall
patient satisfaction.
Response:
Criteria met
90.0%
73.5%
70.0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2020
2021
2022
Immunization Rate
Childhood
Immunization
Rate
Goal (75%)
Good
76.1%
86.0%
88.6%
70%
74%
78%
82%
86%
90%
94%
2020
2021
2022
Mean Composite Score
Patient
Satisfaction -
Ambulatory Care
Goal (90%)
Good
75.0%
78.7%
79.0%
64%
66%
68%
70%
72%
74%
76%
78%
80%
2020
2021
2022
% Within 1st Trimester
Women
Entering
Prenatal Care
Goal (70%)
Good
18
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1.5M
Breast Cancer Screening
Goal:
56% of active female patients age 51 to 74
years will have a mammogram in the past 2 years.
Response:
Criteria met
1.5N
Cervical Cancer Screening
Goal:
70% of active female patients age 24-64, will
have had a PAP test in the past three years or a
PAP+HPV in the past 5 years (age 30-64).
Response:
Criteria met
1.5P
Diabetes Monitoring
A “diabetic patient” is an adult in the diabetes
registry with at least one diagnosis code for diabetes
in the last 18 months.
Goal - Diabetes Glucose Control:
60% of Diabetic
patients will have an HbA1c < 9.
Response:
Criteria met
Goal - Cardiovascular Disease Treatment and
Prevention:
90% of Diabetic patients will receive
guideline-adherent treatment with statin medication.
Response:
Criteria met
1.5O
Adolescent Vaccinations
Goal:
85% of active adolescent patients, age 13-17, will
have at least one does each of Tdap, MCV4, and HPV
vaccine.
Response: Criteria met
78.8%
88.9%
78.5%
70%
74%
78%
82%
86%
90%
94%
2020
2021
2022
% Top Box
Patient
Satisfaction -
Hospital Services
Goal (78%)
Good
54.5%
57.7%
70.0%
50%
54%
58%
62%
66%
70%
74%
2020
2021
2022
% Mammo in Past 2 Years
Active Female
Patients (51-74)
Goal (56%)
Good
67.1%
70.4%
72.0%
64%
66%
68%
70%
72%
74%
76%
2020
2021
2022
% PAP/HPV Screened
Active Female
Patients
Goal (70%)
Good
89.9%
88.6%
89.0%
82%
84%
86%
88%
90%
92%
2020
2021
2022
% Vaccinated
Active Adol (13-17)
w/Tdap, MCV4,
and HPV
Goal (85%)
Good
66.2%
62.8%
65.0%
58%
60%
62%
64%
66%
68%
70%
72%
2020
2021
2022
% with HbA1c ≤9
Diabetes
Glucose Control
Goal (60%)
Good
19
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1.5R
Cigarette Smoking Interventions
Goal:
At least 50% of patients 11 years and older who
smoke, had a visit in their medical home in the last
month (and at least one other in the past year) and
who received an approved cessation intervention
anywhere at Denver Health in the past 6 months.
Response:
Criteria met
1.5S
Flu Vaccinations
Goal:
50% of patients, 6 months of age or older
who have had a visit to a primary care clinic
during the influenza season and who do not have
a contraindication to vaccination will receive the
influenza vaccine.
Response:
Criteria met
1.5Q
Hypertension Control
Goal:
62% of patients identified with hypertension
will have their blood pressure under control as
defined by current standards.
Response:
Criteria met
1.5T
Survival with Trauma
Survival rate for blunt and penetrating trauma
among patients who are not dead on arrival (DOA)
will be maintained within 5% of prior year experience.
Goal - Blunt:
Survival rate for blunt trauma will be
maintained within 5% of 2021 experience, which was
97.4%.
Response:
Criteria met
Goal - Penetrating:
Survival rate for penetrating
trauma will be maintained within 5% of 2021
experience, which was 96.3%
Response:
Criteria met
94.9%
95.5%
97.0%
70%
75%
80%
85%
90%
95%
100%
2020
2021
2022
% Treated w/Statin
Cardiovascular
Disease
Treatment and
Prevention
Goal (90%)
Good
62.1%
60.8%
62.0%
60%
61%
62%
63%
64%
65%
66%
67%
68%
2020
2021
2022
% Controlled BP
Hypertensive
Patients
w/Controlled BP
Goal (62%)
Good
49.7%
49.2%
52.0%
46%
47%
48%
49%
50%
51%
52%
53%
54%
2020
2021
2022
% Smoking Intervention
Cigarette
Smoking
Interventions
Goal (50%)
Good
60.4%
58.1%
55.0%
48%
50%
52%
54%
56%
58%
60%
62%
2020
2021
2022
% Vaccinated for Flu
Flu Vaccinations
Goal (50%)
Good
96.8%
97.2%
97.4%
88%
90%
92%
94%
96%
98%
100%
2020
2021
2022
% Survival
Blunt Trauma
without DOA
Goal: 5% of
prior year
(2022: 92.4%)
Good
20
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1.5U
Joint Commission Quality Measures. Early
Elective Delivery between 37-39 Weeks Gestation
Goal:
The rate of elective delivery between 37-39
weeks as defined by the Joint Commission measure
PC-01 will be maintained at 1.5% or lower.
Response:
Criteria met
97.2%
95.1%
97.1%
88%
90%
92%
94%
96%
98%
100%
2020
2021
2022
% Survival
Penetrating
Trauma without
DOA
Goal: 5% of prior
year
(2022: 91.3%)
Good
0.0%
0.0%
0.0%
0.0%
0.5%
1.0%
1.5%
2.0%
2020
2021
2022
% Early Delivery
Elective Early
Delivery (37 – 39
Weeks)
Goal (≤1.5%)
Good
1.5V
Hospital-Acquired Infection Rates. Adult
Critical Care Central Line Associated Blood Stream
Infection (CLABSI)
Goal - Medical Intensive Care Unit:
Risk-adjusted
rate that is the same or better than the national
Medical ICU rate on the most recent Colorado
Department of Public Health and Environment
(CDPHE) report.
Goal - Trauma Intensive Care Unit:
Risk-adjusted
rate that is the same or better than the national
Trauma ICU rate on the most recent CDPHE report.
Response:
Criteria met
Contract Criterion
2020
2021
2022
Medical Intensive Care Unit
Same
Same
Same
Trauma intensive Care Unit
Better
Same
Same
Adult Critical Care Central Line Associated Blood Stream
Infection (CLABSI)
Hospital-Acquired Infection Rates
1.5W
HIV Prevention - Pre and Post Exposure
Response:
Criteria met
Contract Criterion
2020
2021
2022
Number of persons started on Pre-Exposure
Prophylaxis (PrEP) in STD Clinic/Ambulatory Care
704
724
1230
Number of persons who receive non-occupational
Post-Exposure Prophylaxis (PEP) in STD Clinic only
116
105
105
HIV Prevention - Pre and Post Exposure
21
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Statistic
2020
2021
2022
Trend
DH Medicaid Choice Average Monthly
Enrollment
100,543
107,637
110,350
Inpatient Admissions
23,592
21,579
21,374
Inpatient Days (Equivalent Census Days)
132,061
135,570
129,678
Emergency Room Encounters
71,680
91,773
108,562
Urgent Care Visits
1
70,593
84,402
102,979
ER Cost/Visit
$1,144
$908
$1,035
Top 25 DRGs for MI population
NICU days
5,825
5,707
5,782
CT Scans
60,106
69,450
69,384
MRIs
12,777
16,441
17,434
Outpatient Surgeries
7,765
8,992
9,225
Ambulatory Care Encounters
(reported volumes are building-based)
Ambulatory Care Center
2
84,345
157,435
210,060
Webb Center for Primary Care
3
109,107
100,773
81,703
Gipson Eastside Family Health Center
4
77,753
83,157
82,582
Sandos Westside Family Health Center
5
81,464
81,137
80,134
Lowry Family Health Center
6
50,114
55,118
54,032
Montbello Health Center
6
44,490
39,735
39,585
Park Hill Family Health Center
6
22,656
22,564
21,721
La Casa/Quigg Newton Family Health Center
7
23,810
24,267
24,358
Westwood Family Health Center
7
22,719
22,533
22,793
Federico Pena Family Health Center
8
80,434
83,528
83,689
Sloan's Lake Health Center
9
2,519
12,227
14,092
Other
10
250,948
231,827
241,728
OP Behavioral Health Visits
11
168,208
151,306
149,254
Total Ambulatory Care Encounters
1,018,567
1,065,607
1,105,731
OP Pharmacy Cost/per patient
$67
$70
$85
Changes for 2022 Reporting:
1
Includes Adult Urgent Care Clinic (AUCC), Downtown Urgent Care (DUC), Pediatric Urgent Care (PEDUC), Pena Urgent
Care, and Virtual Urgent Care
2
Includes ACS services provided in Outpatient Medical Center (OMC): Adult, AUCC, Dental, ENT, Eye, IBH (Integrated
Behavioral Health) NOTE: OMC opened in Q2 2021; reported 2020 volume is from Davis pavilion clinics that relocated to
OMC.
3
Includes ACS services: Adult, Geriatrics, IOC, Pediatrics, Pediatric Dental, Pediatric Specialty
4
Includes ACS services: Adult, Dental, IBH, Pediatrics, Rehab, and Womens Care
See Final DRG Table
10
Includes services at clinics not included in building-based volumes: Chanda, Rose Andom, all Mobile Clinics, SBHC,
SAFE (FCC), MHCD, Pav B/C Women's Care, AUCC, Ortho, OT, PT, and ST
11
Includes OBHS clinics: DH PAV G CHILD MEN, DH PAV G STEP, DH PAV K METHADONE, DH PAV K SUBOXONE, DH PAV
L ADT BEHHEALTH as well as Methodone and Suboxone doses
5
Includes ACS services: Adult, Dental, IBH, Pediatrics, Rehab, and Womens Care
6
Includes ACS services: Dental, Family Medicine, and IBH
7
Includes ACS services: Family Medicine and IBH
8
Includes ACS services: Dental, Family Medicine, IBH, and Urgent Care
9
New Denver Health Clinic not identified in current Operating Agreement language. Location opened Q3 2020. Includes
ACS services: Family Medicine and IBH
H.
Performance Criteria Table - Ambulatory Encounters (1.5 numbering follows the Authority's annual report)
Response:
Criteria met
See table below for details.
22
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I.
The Authority’s Medical Center's observed total
inpatient mortality will be the same or better
than the expected as measured by Vizient, the
largest member-driven health care performance
improvement company in the country.
Response:
Criteria met
For the most recent full year of data available from
Vizient (October 2021 - September 2022), Denver
Health's observed inpatient mortality was 20% better
than the expected mortality, adjusted for patient
complexity.
J.
The Authority will maintain appropriate
accreditation for the major national accrediting
organizations as a measure of quality care.
Response:
Criteria met
Denver Health maintains full accreditation from The
Joint Commission on five distinct regulatory surveys
covering A) the hospital and specialty clinics, b) the
federally qualified health centers and school-based
clinics, c) the hospital laboratory, d) the ambulatory
care services laboratory, and e) the opioid treatment
program. In 2022, The Joint Commission conducted
both of the laboratory services surveys, resulting in
maintenance of full accreditation.
K.
The Authority will maintain national Residency
Review Committee accreditation for its training
programs.
Response:
Criteria met
Denver Health enjoys Continued Accreditation from
ACGME for its three accredited medical residencies,
Approval without Reporting Requirements
from CODA for its three dental residencies, and
Transferred Accreditation from CPME for its podiatry
residency which relocated from the VA Hospital.
L.
The Authority will include in the May 1 annual
report, a schedule of the number of patients treated
during the reporting year by county, gender and
ethnicity. The Authority will develop a report of the
same data by census tract or zip code for Denver
users. A separate report will be prepared detailing
the same information for the homeless.
Response:
Criteria met
See tables on the following pages for details.
23
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2022
Rank
DRG#
DRG NAME
Total
2021
Rank
2020
Rank
1
885
PSYCHOSES
108
1
1
2
871
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC
72
2
2
3
794
NEONATE WITH OTHER SIGNIFICANT PROBLEMS
54
9
7
4
621
O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC
50
N/A
N/A
5
807
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT
CC/MCC
41
N/A
5
6
833
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES
WITHOUT CC/MCC
34
18
N/A
7
872
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT
MCC
33
8
N/A
7
202
BRONCHITIS AND ASTHMA WITH CC/MCC
33
N/A
20
9
641
MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS
AND ELECTROLYTES WITHOUT MCC
32
N/A
20
10
917
POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC
31
N/A
N/A
11
193
SIMPLE PNEUMONIA AND PLEURISY WITH MCC
29
N/A
N/A
12
603
CELLULITIS WITHOUT MCC
28
N/A
N/A
13
286
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC
CATHETERIZATION WITH MCC
26
21
22
14
419
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT
CC/MCC
24
N/A
N/A
15
897
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT
REHABILITATION THERAPY WITHOUT MCC
23
N/A
N/A
16
640
MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS
AND ELECTROLYTES WITH MCC
20
N/A
17
16
832
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES
WITH CC
20
24
N/A
16
247
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-
ELUTING STENT WITHOUT MCC
20
N/A
N/A
19
660
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM
WITH CC
19
N/A
N/A
20
896
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT
REHABILITATION THERAPY WITH MCC
18
N/A
N/A
21
246
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-
ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS
16
N/A
N/A
22
906
HAND PROCEDURES FOR INJURIES
15
N/A
25
22
482
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT
15
N/A
22
22
812
RED BLOOD CELL DISORDERS WITHOUT MCC
15
N/A
N/A
22
795
NORMAL NEWBORN
15
N/A
N/A
26*
494
LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP,
FOOT AND FEMUR WITHOUT CC/MCC
14
N/A
N/A
26*
418
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC
14
N/A
N/A
Top 25 DRG's for Medically Indigent Population
*Displaying top 26 DRGs due to four-way tie for 22nd
L.
24
DENVER HEALTH
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County
Users
Visits
Users
Visits
Users
Visits
Users
Visits
Adams
20,819
92,009
27,150
122,883
25,730
115,254
Alamosa
22
73
30
103
29
91
Arapahoe
24,392
106,333
33,137
142,384
28,863
126,786
Archuleta
7
11
13
25
7
71
Baca
1
1
3
6
4
8
Bent
7
15
7
76
10
52
Boulder
1,238
3,345
2,107
5,679
1,546
4,429
Broomfield
579
2,146
941
3,591
746
2,916
Chaffee
27
58
33
87
46
122
Cheyenne
4
13
4
18
8
19
Clear Cree
k
115
294
170
515
149
424
Conejos
5
7
9
28
12
28
Costilla
6
10
5
17
11
35
Crowley
2
5
4
6
6
23
Custer
10
35
10
22
10
40
Delta
16
29
20
64
26
49
Denver
137,906
642,649
179,606
854,392
155,914
740,903
Dolores
2
2
5
11
1
2
Douglas
2,346
8,142
4,476
14,482
2,902
10,520
Eagle
168
370
174
412
218
497
El Paso
937
2,652
1,118
3,301
1,206
3,290
Elbert
109
281
157
510
114
391
Fremont
35
139
48
138
39
102
Garfield
60
155
77
143
82
188
Gilpin
50
213
70
190
61
158
Grand
1,104
2,488
1,543
3,717
948
2,382
Gunnison
23
46
29
59
23
44
Hinsdale
0
0
0
0
1
1
Huerfano
11
36
16
57
10
29
Jackson
5
11
6
22
47
60
Jefferson
20,651
93,547
28,604
123,729
22,662
100,917
Kiowa
0
0
2
4
3
4
Kit Carson
18
82
10
62
25
105
La Plata
18
50
30
51
33
83
Lake
29
91
42
131
84
147
Larimer
416
1,016
643
1,741
514
1,179
Las Animas
12
48
19
88
17
109
Lincoln
31
129
50
237
75
259
Logan
53
194
45
233
41
143
Unduplicated Users and Patient Visits by Colorado County
2020
2021
Trend
2022
2020
2021
2022
Trend
Total Unduplicated Users
213,109
282,964
244,768
Total Visits
963,102
1,287,417
1,120,101
Unduplicated Users and Patient Visits by Colorado County
L.
25
DENVER HEALTH
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|
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| Page
County
Users
Visits
Users
Visits
Users
Visits
Users
Visits
Unduplicated Users and Patient Visits by Colorado County
2020
2021
Trend
2022
Mesa
77
219
95
259
75
166
Mineral
2
7
1
10
1
1
Moffat
14
45
12
36
15
26
Montezuma
7
11
21
38
20
43
Montrose
18
33
31
59
19
49
Morgan
99
422
98
360
136
417
Otero
30
102
22
85
29
140
Ouray
3
4
7
15
1
10
Park
106
371
172
477
143
404
Phillips
8
18
5
22
8
9
Pitkin
17
70
23
58
19
24
Prowers
13
55
16
85
15
41
Pueblo
222
758
251
753
234
774
Rio Blanco
6
15
7
15
4
22
Rio Grande
17
52
28
48
31
111
Routt
38
66
52
105
49
114
Saguache
4
20
12
31
9
42
San Juan
0
0
0
0
0
0
San Miguel
6
8
9
12
14
21
Sedgwick
2
7
4
11
42
79
Summit
118
337
153
490
196
520
Teller
24
54
32
101
31
79
Washington
13
73
24
106
85
142
Weld
1,023
3,609
1,458
4,982
1,355
4,988
Yuma
8
21
18
45
14
19
Total
213,109
963,102
282,964
1,287,417
244,768
1,120,101
L.
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26
2020
2021
2022
Trend
Total Unduplicated Users
144,088
191,325
160,940
Total Visits
672,257
889,841
759,113
Unduplicated Users and Patient Visits by Denver County Zip Code
L.
Zip Code
Users
Visits
Users
Visits
Users
Visits
Users
Visits
80201
136
646
199
1,062
146
818
80202
2,276
8,742
3,731
13,654
3,274
12,061
80203
4,327
17,315
6,260
27,197
5,306
22,478
80204
17,995
84,984
22,787
103,325
18,627
86,260
80205
8,670
41,609
11,073
53,488
9,596
46,573
80206
2,315
10,380
3,797
15,585
2,517
11,201
80207
3,868
19,173
5,159
25,257
4,142
20,861
80208
15
38
25
84
13
26
80209
1,899
7,719
3,558
12,925
2,413
9,843
80210
2,065
8,131
3,903
14,071
2,473
10,145
80211
5,840
28,124
8,071
37,470
6,307
29,715
80212
2,013
9,701
2,999
13,342
2,082
10,252
80216
4,645
22,379
5,699
28,440
5,471
26,654
80217
29
99
54
175
34
129
80218
2,939
13,143
4,332
18,734
3,446
14,754
80219
27,570
132,839
32,807
167,404
29,340
148,059
80220
4,670
20,935
6,434
28,654
4,947
23,685
80222
2,671
13,382
3,734
18,211
3,006
15,014
80223
7,082
34,790
8,774
45,595
7,629
39,003
80224
2,410
11,444
3,411
15,271
2,871
13,298
80227
3,155
14,580
4,476
20,358
3,708
17,365
80230
1,029
4,805
1,563
6,811
1,156
5,606
80231
4,587
20,532
6,104
27,096
5,239
23,849
80235
614
3,090
903
4,173
677
3,394
80236
3,273
15,069
4,249
20,075
3,705
17,657
80237
1,599
7,438
2,543
11,113
2,025
9,588
80238
1,314
5,446
2,452
9,374
1,561
6,802
80239
13,491
61,875
16,578
79,248
15,109
69,790
80243
1
2
3
7
4
6
80244
1
17
5
18
4
26
80246
1,569
6,713
2,226
9,612
1,980
8,999
80247
3,800
18,230
5,092
23,724
4,425
20,277
80248
1
8
6
46
3
11
80249
6,160
28,562
8,212
37,692
7,635
34,586
80250
39
281
78
452
31
244
80251
0
0
1
23
1
1
80252
0
0
1
2
1
1
80256
1
1
1
2
0
0
80257
0
0
0
0
1
1
80259
2
2
2
3
1
1
80261
1
1
6
8
10
19
80262
0
0
0
0
2
6
80263
1
2
3
5
2
6
80264
0
0
0
0
1
1
Unduplicated Users and Patient Visits by Denver County Zip Code
3-Year Trend
2020
2021
2022
27
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L.
Zip Code
Users
Visits
Users
Visits
Users
Visits
Users
Visits
Unduplicated Users and Patient Visits by Denver County Zip Code
3-Year Trend
2020
2021
2022
80265
0
0
0
0
0
0
80266
4
11
0
0
2
2
80271
0
0
0
0
0
0
80273
1
1
2
2
0
0
80274
2
2
2
5
6
28
80281
1
1
0
0
1
2
80290
2
4
3
14
2
3
80291
0
0
1
1
1
3
80293
2
8
3
24
2
3
80294
2
2
1
4
3
5
80299
1
1
2
5
2
2
Total
144,088
672,257
191,325
889,841
160,940
759,113
28
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Sex At Birth
Race
Users
Total Visits
Users
Total Visits
F
African-American
17,226
91,437
F
Amer/Alaskan Native
845
4,900
F
Asian
5,257
24,453
F
Hispanic
68,665
375,135
F
Native-Hawaiian
77
303
F
Other
4,354
16,779
F
Oth-Pacific-Islander
270
1,284
F
Unknown
39
91
F
White-Caucasian
38,681
166,420
F
NULL
737
784
Female Total
136,151
681,586
Sex At Birth
Race
Users
Total Visits
Users
Total Visits
M
African-American
16,031
63,432
M
Amer/Alaskan Native
760
4,019
M
Asian
3,899
14,812
M
Hispanic
55,624
220,499
M
Native-Hawaiian
52
167
M
Other
4,462
13,698
M
Oth-Pacific-Islander
208
695
M
Unknown
35
74
M
White-Caucasian
39,870
146,062
M
NULL
991
1,048
Male Total
121,932
464,506
Sex At Birth
Race
Users
Total Visits
Users
Total Visits
Unknown
African-American
15
71
Unknown
Amer/Alaskan Native
2
7
Unknown
Asian
6
36
Unknown
Hispanic
59
308
Unknown
Other
26
88
Unknown
Oth-Pacific-Islander
2
4
Unknown
Unknown
1
1
Unknown
White-Caucasian
166
844
Unknown
NULL
31
32
Unknown Total
308
1,391
Grand Total
258,391
1,147,483
**Out of State users and visits represent 13,623 and 27,382 respectively
* Table uses Derived Race as identified by Epic
2022 Unduplicated Users and Visits by Sex Assigned At Birth and Race*
(Colorado and Out-of-State Users**)
2022
3-Year Trend
L.
29
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L.
2020
2021
2022
Trend
Total Unduplicated Users
8,414
7,654
8,549
Total Visits
29,640
25,046
34,993
HOMELESS Unduplicated Users and Patient Visits by Colorado County
County
Users
Visits
Users
Visits
Users
Visits
Users
Visits
Adams
170
579
146
462
314
1,332
Alamosa
0
0
0
3
0
0
Arapahoe
170
564
184
622
415
1,797
Archuleta
0
0
0
0
0
2
Baca
0
0
0
0
0
0
Bent
0
1
0
1
5
13
Boulder
8
29
13
42
36
177
Broomfield
1
3
1
6
8
33
Chaffee
0
0
0
0
1
5
Cheyenne
0
0
0
0
0
0
Clear Creek
2
6
9
26
5
30
Conejos
0
0
0
0
0
0
Costilla
0
0
1
1
0
0
Crowley
0
0
0
0
2
3
Custer
0
0
0
0
0
0
Delta
0
0
0
0
0
0
Denver
7,804
27,617
7,035
23,031
7,259
29,525
Dolores
0
1
0
0
0
0
Douglas
24
64
10
45
21
77
Eagle
1
6
0
1
0
6
El Paso
3
13
11
32
20
61
Elbert
0
0
1
5
0
1
Fremont
0
0
0
0
3
4
Garfield
1
4
0
0
0
0
Gilpin
0
0
0
1
0
1
Grand
1
1
0
0
4
11
Gunnison
2
6
0
1
0
0
Hinsdale
0
0
0
0
0
0
Huerfano
0
1
0
0
0
0
Jackson
0
0
0
0
0
0
Jefferson
180
582
184
590
338
1,450
Kiowa
0
0
0
0
0
0
Kit Carson
0
0
0
0
2
4
La Plata
0
4
0
0
0
0
Lake
0
0
1
1
0
0
Larimer
2
15
5
12
6
28
Las Animas
0
0
1
3
1
8
Lincoln
0
0
0
0
1
3
Logan
0
1
0
1
0
0
HOMELESS Unduplicated Users and Patient Visits by Colorado County
2020
Trend
2021
2022
30
DENVER HEALTH
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|
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| Page
L.
County
Users
Visits
Users
Visits
Users
Visits
Users
Visits
HOMELESS Unduplicated Users and Patient Visits by Colorado County
2020
Trend
2021
2022
Mesa
3
12
2
5
5
17
Mineral
0
0
0
0
0
0
Moffat
0
0
0
0
0
2
Montezuma
0
0
0
0
1
2
Montrose
0
0
0
0
3
14
Morgan
2
6
2
5
0
2
Otero
0
0
1
1
3
11
Ouray
0
0
0
0
0
0
Park
1
6
0
1
2
7
Phillips
0
0
0
0
1
2
Pitkin
2
3
0
0
0
0
Prowers
0
0
0
0
2
3
Pueblo
3
12
1
7
5
19
Rio Blanco
0
0
0
0
0
0
Rio Grande
0
0
0
0
0
0
Routt
0
0
0
0
3
15
Saguache
0
0
0
0
0
0
San Juan
0
0
0
0
1
1
San Miguel
0
0
0
0
0
0
Sedgwick
0
0
0
0
0
0
Summit
1
2
3
6
3
6
Teller
1
1
0
0
0
0
Washington
0
0
0
1
0
0
Weld
6
27
3
10
21
81
Yuma
0
0
0
0
0
0
NULL
26
74
40
124
58
240
Total
8,414
29,640
7,654
25,046
8,549
34,993
31
DENVER HEALTH
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2020
2021
2022
Trend
Total Unduplicated Users
7,874
7,072
7,280
Total Visits
27,773
23,108
29,656
HOMELESS Unduplicated Users and Patient Visits by Denver County Zip Code
Zip Code
Users
Visits
Users
Visits
Users
Visits
Users
Visits
80201
9
35
17
43
41
165
80202
49
190
40
113
124
524
80203
89
365
81
287
166
718
80204
6,100
21,447
5,450
17,953
4,021
16,471
80205
656
2,325
710
2,244
1,011
3,937
80206
42
126
30
84
67
247
80207
29
134
31
78
42
219
80208
5
14
1
6
1
1
80209
21
99
12
50
39
167
80210
20
76
26
74
46
161
80211
85
334
52
202
142
610
80212
12
48
22
73
37
200
80216
80
284
90
271
167
700
80217
4
17
1
1
4
28
80218
151
423
63
199
143
522
80219
164
629
120
415
352
1,416
80220
70
260
61
166
189
720
80222
23
77
18
60
38
159
80223
36
127
43
143
121
574
80224
45
137
19
57
63
239
80227
13
42
3
17
36
135
80230
5
27
9
18
26
87
80231
18
64
36
98
45
218
80235
5
9
3
10
1
14
80236
17
67
20
64
47
168
80237
6
19
4
15
18
76
80238
8
21
2
6
7
38
80239
85
283
75
247
171
652
80243
0
0
0
0
0
0
80244
0
0
0
0
0
0
80246
7
21
7
29
57
216
80247
12
43
11
40
31
163
80248
0
0
0
0
0
0
80249
8
27
10
29
25
107
80250
0
3
4
14
1
3
80251
0
0
0
0
0
0
80252
0
0
1
2
1
1
80256
0
0
0
0
0
0
80257
0
0
0
0
0
0
80259
0
0
0
0
0
0
80261
0
0
0
0
0
0
80262
0
0
0
0
0
0
80263
0
0
0
0
0
0
HOMELESS Unduplicated Users and Patient Visits by Denver County Zip Code
2020
3-Year Trend
2021
2022
L.
32
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Zip Code
Users
Visits
Users
Visits
Users
Visits
Users
Visits
HOMELESS Unduplicated Users and Patient Visits by Denver County Zip Code
2020
3-Year Trend
2021
2022
80264
0
0
0
0
0
0
80265
0
0
0
0
0
0
80266
0
0
0
0
0
0
80271
0
0
0
0
0
0
80273
0
0
0
0
0
0
80274
0
0
0
0
0
0
80281
0
0
0
0
0
0
80290
0
0
0
0
0
0
80291
0
0
0
0
0
0
80293
0
0
0
0
0
0
80294
0
0
0
0
0
0
80299
0
0
0
0
0
0
Total
7,874
27,773
7,072
23,108
7,280
29,656
L.
33
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Sex At Birth
Race
Users
Total Visits**
Charges
Users
Visits**
Charges
F
African-American
352
1,376
7,323,052
$
F
Amer/Alaskan Native
59
286
1,004,810
$
F
Asian
11
41
120,296
$
F
Hispanic
772
3,377
15,968,834
$
F
Native-Hawaiian
0
2
23,550
$
F
Other
61
252
937,801
$
F
Oth-Pacific-Islander
1
3
12,122
$
F
Unknown
0
0
-
$
F
White-Caucasian
937
3,918
22,919,245
$
F
NULL
5
22
97,997
$
Female Total
2,198
9,277
48,407,708
$
M
African-American
1,250
4,956
34,197,358
$
M
Amer/Alaskan Native
203
783
4,877,881
$
M
Asian
36
150
896,272
$
M
Hispanic
1,629
6,814
52,839,240
$
M
Native-Hawaiian
0
5
25,019
$
M
Other
124
529
3,482,488
$
M
Oth-Pacific-Islander
0
14
56,906
$
M
Unknown
1
2
4,419
$
M
White-Caucasian
3,151
12,649
108,489,278
$
M
NULL
12
39
220,208
$
Male Total
6,406
25,941
205,089,069
$
Unknown
African-American
1
1
2,272
Unknown
White-Caucasian
6
17
110,161
Unknown
NULL
1
1
3,801
Unknown Total
8
19
116,234
$
Grand Total
8,612
35,237
253,613,011
$
2022 HOMELESS Unduplicated Users and Visits by Sex Assigned At Birth and Race*
* Table uses Derived Race as identified by Epic
**Visits represent current process in Epic for tracking homeless population
3-Year Trend
2022
L.
05
A-2
Emergency
Medical
Services
34
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35
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Appendix A-2 Emergency Medical Services
1.4
Performance Criteria
Each component of the Emergency Medical
Response Services (EMRS), including the Authority
and Department of Safety, and certain stakeholders,
including the Mayor’s Office, City Council, and
the Auditor’s Office, will designate representation
on the EMRS Advisory Committee, which will
meet regularly to monitor system performance,
identify and recommend strategies for innovation
and improvement, and provide the necessary
collaboration and accountability to ensure continued
high delivery of EMS responses and services. The
performance metrics (including any data parameters
or exclusions), advisory committee composition,
and strategic framework will be documented in a
mutually agreed-upon EMRS Advisory Committee
Memorandum of Understanding. The parties have
recommended improvements to the system and
are committed to continuing improvements to the
system that have improved and will continue to
improve overall system performance. The parties
further agree to monitor all aspects of EMRS
performance, including response times and clinical
outcomes, and to work with each other in good faith
to identify potential options to achieve the desired
EMRS performance, which options may include
but are not limited to, revisiting the current EMRS
performance metrics, staffing or scheduling changes,
alternative response mechanisms, equipment and
infrastructure investments.
Response:
Criteria met
A.
The Utilization/Hour rate will be at or below 0.5
transports/hour (system wide).
Response:
Criteria met
0.39
0.46
0.43
0.00
0.10
0.20
0.30
0.40
0.50
0.60
2020
2021
2022
Utilization Rate
Utilization
Rate
Goal (0.5)
Good
05:43
06:00 06:00
00:00
01:26
02:53
04:19
05:46
07:12
2020
2021
2022
Minutes
Time to 12-
lead
Goal (05:45)
Good
02:49
03:09
04:00
00:00
01:26
02:53
04:19
05:46
2020
2021
2022
Minutes
Time to Alert
Goal (05:00)
Good
(v)
Authority’s Clinical Criteria. The following clinical
performance measures for each call will be reported
by the Authority in its quarterly performance report:
1.
Median elapsed target of 5 minutes 45 seconds
or fewer from paramedics’ arrival time to initial
recording of 12 lead ECG for suspected cardiac chest
pain.
Response:
Criteria not met
Variance Explanation:
Accurate data collection for 12-lead to STEMI
alert times was a challenge in 2022. Denver Health
Paramedic Division (DHPD) implemented measures
to improve provider documentation and will continue
to investigate cardiac monitor upload issues.
2.
Median elapsed target of 5 minutes or fewer
from qualifying 12 lead ECG to hospital notification
for patients meeting STEMI (cardiac alert) criteria
(targets to be added).
Response:
Criteria met
3.
Median elapsed transport ambulance scene
time of 9 minutes or fewer from time of arrival
to departure for blunt trauma patient meeting
emergency transport criteria. Exclusions to this are
extrication delays, patient access/staging, multiple
patient incidents.
Response:
Criteria met
36
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08:00
07:12
08:06
00:00
01:26
02:53
04:19
05:46
07:12
08:38
10:05
2020
2021
2022
Minutes
Blunt
Trauma
Goal
(09:00)
Good
4.
Median elapsed transport ambulance scene
time of 6 minutes or fewer from time of arrival to
departure for penetrating trauma patient meeting
emergency transport criteria. Exclusions to this are
extrication delays, patient access/staging, multiple
patient incidents.
Response:
Criteria met
05:35
04:37
05:05
00:00
01:26
02:53
04:19
05:46
07:12
2020
2021
2022
Minutes
Penetrating
Trauma
Goal (06:00)
Good
Out-of-hospital cardiac arrest survival rate reported
under the Utstein Criteria definition for long-term
performance purposes and with appropriate
identification of comparison date ranges and lags in
comparison reporting.
Response:
Criteria disposition pending data availability.
Utstein
2020
2021
2022
Trend
Actual
33.9%
36.8 *
*Data unavailable until after 4/30/2023
5.
The Authority shall be responsible for meeting its
time and clinical performance criteria. The Authority
can meet its response time performance criteria by
meeting the 9-minutes ALS Response time of 90%
from unit assigned to unit arrived.
Response:
Criteria not met
90.3%
84.5%
81.2%
0%
20%
40%
60%
80%
100%
2020
2021
2022
% Compliance
Compliance
Goal (90%)
Good
Variance Explanation:
During 2022, the Paramedic Division faced staffing
retention and hiring challenges while experiencing
increased call volume. DHPD has an aggressive
hiring/retention plan and is exploring ways to reduce
demand where possible.
(vi)
In support of the Denver Community Addictions
Rehabilitation and Evaluation Services (CARES),
the Emergency Services Patrol (ESP) will transport
individuals experiencing substance misuse to the
Denver CARES facility. If serious medical problems
are evident, the client is taken by ambulance to
Denver Health Medical Center. ESP van service will
operate sixteen- hours/day seven days/week.
Response:
Criteria met
(vii)
An ESP average response time of 30 minutes
or fewer will be provided, with that time being
calculated as the number of minutes from the
dispatcher notifying the van to the time of arrival
on the scene. A goal of 30 minutes will be set for
contract year 2022 based on available resources.
Emergency Services Patrol:
Average response time
Response:
Criteria met
10.52
11.12
11.34
0
5
10
15
20
25
30
35
2020
2021
2022
Minutes
ESP Average
Response
Time
Goal (30
minutes)
Good
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Total calls for service
Number of clients picked up per shift
Number of shifts worked per month
Response:
Criteria met
ESP Van Scheduled Shift Statistics
2020
2021
2022
Trend
Total Calls for Service
8,831
7,622
6,067
Avg # Clients Transported per Shift
8
7
6
Avg # Shifts Worked per Month
82
71
76
(viii)
Reporting – Performance reports will be
analyzed continuously by the EMRS Analyst who
will report to the members of the EMRS Advisory
Committee at least bi-monthly regarding system
performance. A system performance report will
be made at least annually by the EMRS Advisory
Committee to the leadership of the City and the
Authority. The parties recognize that the tiered
emergency response system at times may not
meet one or more goals of the NFPA Standards. The
parties understand and agree that coordination and
cooperation will be needed to share data and provide
system performance reporting.
1.
Compliance – The percentage of responses with
response times less than or equal to the time criteria
identified above for each category and service level;
i.e. how many times out of 100 was the time criteria
met.
2.
Time Performance – Using the same data set as
for compliance, the time (in minutes and seconds)
at which 90% of responses fall at or below; e.g. 90%
compliance for total response time was achieved at
11:00 as an overall EMRS metric.
3.
Exclusions – The count of excluded calls, by type,
will be reported, in each report.
Response:
Criteria met
The required reports have been submitted by the
City’s Director of 911 Communications Center and the
Authority has attended monthly meetings.
06
A-3
Public
Health Services
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Public Health Services
2020
2021
2022
Trend
Total Immunization Visits with Outreach
9,267
24,814*
11,651
Total Vaccinations Provided
12,870
28,997*
18,644
Patient Encounters
11,384
11,171
12,384
Dental Encounters
78
**
**
Patient Encounters
12,332
15,399
14,023
New TB Cases
33
47
36
Total TB Visits with Outreach
13,331
12,061
17,296
Birth and Death Certificates Registered
60,257
66,038
***
*Increased volume due to COVID-19 vaccine administration
***Vital Records services transferred to DDPHE in Q4 2021
**Dental Clinic closed in 2020 due to COVID-19. Patients are referred to Outpatient Medical Center Dental
Immunization/Travel Clinic
Infectious Disease Clinic
Sexual Health Clinic
Tuberculosis Clinics
Vital Records
Appendix A-3 Public Health Services
1.4 Performance Criteria
A.
The Authority will provide an annual report by May of the following year being reported on, which includes
performance statistics for the year and the two previous fiscal years, for the following items:
Response:
Criteria met
Annual report provided for the metrics listed below.
B.
The Authority will provide the following performance statistics which includes the goals and metrics for
public health functions of Public Health Institute at Denver Health (PHIDH). The frequency of reporting is
provided in the table. Metrics reported monthly will accompany the invoice.
Response:
Criteria met
The following performance statistics were provided Monthly (N/A = statistics without goals):
Program
Objective
Metric
YE Total
Resul
t
ID-Clinic
HIV
Ready access for patients
Number of in-clinic medical,
psychiatric, and social work
encounters provided (face-to-face
or telehealth)
12,384
N/A
Operating Agreement Monthly Measurements by Program 2022
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Program
Objective
Metric
YE Total
Resul
t
Operating Agreement Monthly Measurements by Program 2022
Number of vaccines provided in the
clinic (non-travel)
11,981
N/A
Number of vaccines provided in
community settings (schools and
other communit
y
venues)
5,175
N/A
Number of non-travel related in-
clinic visits
7,831
N/A
Number of total in-clinic visits
10,490
N/A
Number of unique patients seen in
t
he clinic
9,234
N/A
Number of unique children
immunized at outreaches
934
N/A
Number of unique adults
immunized in outreaches
1,604
N/A
Number of travel consults
1,814
N/A
Number of travel vaccines
administered in the clinic
2,200
N/A
Care for possible sexually-
transmitted diseases in the STD
Clinic (annual goal = 10,500 visits)
14,023
Reproductive health services
(family planning) in the STD Clinic
(annual
g
oal = 4
,
000 visits)
4,492
STD screening in community
settings (annual goal = 2,000 visits)
2,938
Percent of patients with gonorrhea
or chlamydia treated within 7 days
of diagnosis (annual goal = 80%)
93.0%
Testing in the Sexual Health Clinic
(annual
g
oal= 5,500)
6,502
Community testing in high-risk
venues (annual
g
oal = 800)
1,290
Number of visits provided in
community settings or outreach
9,366
N/A
Number of total TB encounters
(includes in-clinic or outreach)
17,296
N/A
TB Clinic
Provide tuberculosis (TB)
testing, prevention, and
treatment in Denver
Provide access to Denver
residents and visitors to clinical
sexual health services in clinical and
community settings
Sexual Health Clinic
Sexually-transmitted
diseases (other than HIV and
viral hepatitis)
Provide HIV testing in clinical
and community settings
Ready access for residents of and
visitors to Denver to vaccines in
clinical and community settings
Immunization and Travel
Clinic
Vaccine-preventable
infections
Provide travel-related
evaluation and immunizations
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Program
Objective
Metric
Q1
Q2
Q3
Q4
Result
Number of unique
patients seen with
HIV
(annual goal = 900)
1199
1107
1128
1153
Percent of ID Clinic
patients with a viral
load < 200 copies
(annual goal = 88%)
91%
91%
91%
90%
Provide evaluation
and treatment of
Hepatitis C for
persons in Denver
Number of persons
who complete
treatment for
Hepatitis C in the ID
Clinic
(annual goal = 50)
50
56
59
43
Access to pre-
exposure
prophylaxis for HIV
Number of persons
started on PrEP in
STD clinic
(annual goal = 300)
179
162
171
161
Provide testing for
Hepatitis C
among persons at
increased risk in the
STD Clinic
Number of persons
tested for Hepatitis
C (annual goal =
1,200 tests)
1118
1524
1357
1084
Operating Agreement Quarterly Measurements by Program 2022
ID Clinic-HIV
Provide treatment
for persons
with HIV disease in
Denver
Sexual Health
Clinic
Sexually-
transmitted
diseases (other
than HIV and viral
hepatitis)
Response:
Criteria met
The following performance statistics were provided Quarterly (N/A = statistics without goals):
Response: Criteria partially met
The following performance statistics were provided Semi-Annually (N/A = statistics without goals):
Program
Objective
Metric
6/30/2022
12/31/2022
Result
Number of new TB cases
16
20
N/A
Completion of treatment within 12
months (goal
95%)
88%
95%
Contacts to active TB cases with
newly diagnosed latent TB who
start treatment (goal >90%)
67%
33%
Completion of treatment of latent
TB among close contacts to
active cases of smear-positive
pulmonary TB (goal >80%)
100%
80%
Provide evaluation and treatment
of persons with latent TB in Denver
TB Clinic
One year lag in reporting so numbers are skewed due to COVID.
In
addition, there was one contact investigation related to a person being
detained by the ICE Facility. The TB clinic was not given complete
contact information from this facility and unable to complete the
investigation resulting in the poor metric outcomes.
The TB Clinic is
actively working to better partner with this facility and Arapahoe
County Public Health for future investigations.
Operating Agreement Semi-Annual Measurements by Program 202
2
One year lag in reporting so numbers are skewed due to COVID-19
Prevent TB in Denver
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Program
Objective
Metric
2022
Result
Immunization and
Travel Clinic
Vaccine-preventable infections
Assess risks for vaccine
preventable infections in
Denver
Review of opportunities to decrease
vaccine-preventable infections in
Denver
PHIDH completed
assessment work related to
the HPV vaccine and MMR
for 4–6-year-olds and
continued efforts to increase
flu and COVID-19
vaccinations in the
community.
The
Immunization clinic used
MMR rates in 4-6 year olds to
determine which schools
should be the focus of the In
School Immunization
Program.
PHIDH also
partnered with ACS and
School-based health clinics
to increase completion of the
HPV vaccine series among 9-
17 year olds.
N/A
Operating Agreement Annual Measurements by Program 2022
Response:
Criteria met
The following performance statistics were provided Annually (N/A = statistics without goals):
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07
A-4 Denver
Community
Addiction
Rehabilitation and
Evaluation Services
(CARES)
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Appendix A-4 Denver Community
Addictions Rehabilitation and Evaluation
Services (CARES)
1.4
Performance Criteria
A.
One-hundred percent of the women of child-
bearing age utilizing the services of Denver CARES
will be offered a pregnancy test and, if the test is
positive, will be provided referral and follow-up.
Response:
Criteria met
Denver CARES offers pregnancy testing at no cost
to all female patients of child-bearing age. In 2022
there were two positive pregnancy tests and the
patients were referred to Denver Health's Women’s
Services.
Detoxification Program
2020
2021
2022
Trend
Detoxification:
Average Daily Census
65
64
65
Number of clients admitted more than one time for the program year
1,738
5,949
6,408
Number of admissions of clients experiencing homelessness
13,629
11,436
9,814
Number of clients who did not pay any charges due for services rendered
391
7,158
6,071
Number of referrals not admitted
484
535
641
Number of clients admitted for the first time
1,916
2,982
909
Number of clients referred with a DUI
350
204
195
Number of client to staff assaults
19
10
8
Number of client to client assaults
17
2
7
Number of referrals not admitted.
Number of clients admitted for the first time
Number of clients referred with a DUI
Number of client to staff and client to client
assaults
Response:
Criteria met
See table below for details:
The Authority will provide a quarterly report to the
City in an agreed upon format, which indicates the
amount of year-to-date expenses and revenues
for Denver CARES by the 15
th
day of the month
following the end of the quarter after the end of the
reporting period.
The report will also include the following metrics:
Number of clients admitted more than once for
the program year
Number of total clients seen in the program
year
Number of unanticipated or negative events
(seizures, assaults, and serious injuries)
Standard demographics on clients seen in
program year (age, gender, race/ethnicity,
housing status, and Medicaid status)
Response:
Criteria met
See table on the following page. The Denver Health
Finance Department provided regular quarterly
reports to the City with year-to-date expenses and
revenues.
Pregnancy Testing
2020
2021
2022
Trend
# Women of Child-Bearing Age
854
1,248
1,194
# Pregnancy Tests Provided
33
14
34
% of the women of child-bearing age
utilizing the services of Denver CARES were
offered a pregnancy test
100%
100%
100%
% Women Who Received Pregnancy Test
4%
1%
3%
# Positive Results
1
1
2
% Positive Tests
3%
7%
6%
B.
The Authority will provide an annual report by
May 1
st
of the year following the year being reported
on, which includes performance statistics for the
year just ended and the two previous fiscal years,
for the following items:
Detoxification: Average Daily Census
Number of clients admitted more than one time
for the program year
Number of admissions of clients experiencing
homelessness
Number of clients who did not pay any charges
due for services rendered.
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Denver CARES Services
Q1 2022
Q2 2022
Q3 2022
Q4 2022
EOY 2022
Number of clients admitted more than once for
the program year.
1584
1582
1722
1580
6468
Number of total clients seen in the program year
1749
1777
1919
1671
7116
Number of unanticipated or negative events
(seizures, assaults, and serious injuries)
18
12
13
13
56
Demographics of clients seen in program year
Q1 2022
Q2 2022
Q3 2022
Q4 2022
EOY 2022
18-29
409
498
507
436
1850
30-39
501
533
554
515
2103
40-49
356
328
417
335
1436
50-59
314
274
281
231
1100
60+
168
144
160
153
625
Unknown
1
0
0
1
2
Male
1341
1327
1453
1282
5403
Female
408
448
464
387
1707
Unknown
0
2
2
2
6
White or Caucasian
1167
1112
1183
1045
4507
Black or African American
271
226
261
213
971
American Indian or Alaska Native
76
70
62
62
270
Other Pacific Islander
1
2
1
1
5
Native Hawaiian
3
3
2
1
9
Asian
14
13
10
14
51
Other
107
193
208
232
740
Unknown
79
112
128
63
382
Decline to Answer
31
46
64
40
181
Not Hispanic, Latino/a, or Spanish Origin
1175
1114
1189
1057
4535
Hispanic, Latino/a, or Spanish Origin
477
527
560
513
2077
Mexican, Mexican American, or Chicano/a
1
0
0
0
1
Unknown
78
108
129
63
378
Decline to Answer
18
28
41
38
125
Homeless
526
424
505
461
1916
Not Homeless
1223
1353
1414
1210
5200
Have Medicaid
1032
976
1070
923
4001
Don’t have Medicaid
717
801
849
748
3115
Medicaid Status
Age
Gender
Race
Ethnicity
Housing Status
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08
A-6
Medical
Services for
Arrestees,
Pretrial Detainees
and Inmates
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Appendix A-6 Medical Services for
Arrestees, Pretrial Detainees and Inmates
at Denver Health and Hospital Authority
1.6 Performance Criteria and Reports
A.
The Correctional Care Medical Facility (CCMF) is
a Denver Health patient care facility and as such will
comply with Joint Commission on Accreditation of
Healthcare Organizations regulations and review.
Response:
Criteria met
The CCMF follows all Denver Health policies and
procedures aligning with the regulations of Denver
Health's accreditation by the Joint Commission on
Accreditation of Healthcare Organizations. CCMF
continues to be open for Denver prisoner admissions
24 hours a day, 7 days a week. The CCMF is a state-
of-the-art facility, combining both security and
medical care features. Patients are accepted from all
adult-based correctional facilities and jurisdictions.
20 beds (including one dedicated psychiatric
observation room), six holding cells, electronic
surveillance and door control, vehicular sally port,
and a dedicated ten room outpatient area are some
of the key features of this facility.
CCMF Services
2020
2021
2022
Trend
Discharges
Denver
304
304
356
All Jurisdictions
507
522
610
Total Hospital Days
Denver
1,081
1,262
1,789
All Jurisdictions
2,031
2,220
2,742
Average Length of Stay
Denver
3.5
5.0
5.2
All Jurisdictions
3.9
4.0
4.3
CCMF Outpatient Clinic Visits
Denver
707
831
885
All Jurisdictions
3,060
2,891
2,927
Denver Jail Patients Seen in ED
1,942
1,903
1,917
B.
The Authority will continue to provide the City
with mutually agreed upon standardized Utilization
Management (UM) reports each month.
In addition,
the following information shall be provided to the
Sheriff or his/her designee:
(i) a daily census report for all inpatients at
CCMF or at Denver Health Medical Center
(DHMC);
(ii) within sixty (60) days, monthly patient
data including the patient name, medical
record number, total length of stay, admit and
discharge dates, the Authority charges, City
Cost, patient DOB, split billing information.;
(iii) within sixty (60) days, monthly reports
including ambulance, facility and physician
billing;
(iv) within sixty (60) days, monthly third-party
billing reports including patients name, admit
and discharge dates, split billing information,
sum of charges, sum of City cost, amount
collected from third party, name of third party
payor, credits/debits to City; and,
(v) within sixty (60) days, a monthly A-6 report
and B-3 report as agreed upon by the City and
the Authority.
Response:
Criteria met
All above listed reports were submitted to the City
within required timelines.
C.
The Authority shall continue to develop and
submit financial reports at least monthly to enable
the City and the Authority to evaluate payment
mechanisms and to improve understanding of
costs.
If the ongoing billing methodology work group
(consisting of representatives from the Authority
and the City) agrees, the City and the Authority may
amend this agreement as to payment methodology.
Response:
Criteria met
During 2022, the Authority continued its monthly
financial reporting to include summary and detailed
information. These reports have enabled analyses
of the many different services on various levels.
The current reporting format and content has been
approved by both the City and the Authority.
D.
If any third-party payment is denied or reduced
to less than full payment, the Authority shall provide
detailed documentation of such (including the
stated reason and any available appeal procedures)
to the City within fifteen (15) days.
The Authority
shall timely take such action as is necessary and
reasonable to challenge or appeal the denial or
reduced payment, where warranted under the law
and the rules of ethics as long as the City pays all
necessary, reasonable and preauthorized (in writing)
associated fees and expenses and the City’s written
preauthorization is received within three (3) days of
the Sheriff’s or his/her designee’s receipt of written
notice from the Authority of the denial or reduction.
However, the City shall not pay for the processing
and re-submission of third party claims that can be
accomplished by Authority staff.
Response:
Criteria met
The City is notified monthly of all denials related to
third-party payments. Where there are concerns,
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these concerns are resolved in accordance with the
language outlined above.
E.
Upon completion of providing patient care
services to the City and County of Denver arrestees,
pretrial detainees and inmate population, it is agreed
that the Authority will notify the Sheriff’s Department
of the final medical disposition at which time the
Sheriff’s Department shall arrange for transport
of the detainee or inmate within the agreed upon
median target of 50 minutes.
Response:
Criteria met
See table below for details.
From Emergency Department
2020
2021
2022
Trend
Actual
41
42
49
Target
60
50
50
50
Sheriff Department Median Time to Transport (Minutes)
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09
A-7 Denver Health
Medical Plan and
City Employee
Healthcare
Opinion Survey
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Appendix A-7 Denver Health Medical Plan and City Employee Healthcare Opinion Survey
1.3
Performance Criteria
A.
The Health Plan will meet all Performance Standards defined in the annual contract.
Response: Criteria met
At the request of the City and County of Denver, Denver Health Medical Plan (DHMP) provided monthly
utilization and cost reports including data on:
Enrollment
Medical Claims
Pharmacy Claims
Refer to tables below for key performance metrics for the 2022 performance period.
DHMO
HDHP
DHMO
HDHP
CSA
288
411
415
627
DERP
43
43
46
48
DPPA
9
35
13
53
Total
340
489
474
728
Enrollment Summary (Snapshot December 2022)
Total Subscribers
Total Members
DHMO
HDHP
DHMO
HDHP
CSA
41%
59%
40%
60%
DERP
50%
50%
49%
51%
DPPA
20%
80%
20%
80%
Plan Type Summary (Snapshot December 2022)
Total Subscribers
Total Members
Medical
Inpatient
2
Medical
Outpatient
3
Medical
Professional
4
Total Medical
Capitation
Rx
5
CSA DHMO
299,642.74
$
239,557.72
$
98,013.87
$
637,214.33
$
1,794,355.00
$
403,932.05
$
CSA HDHP
248,559.06
$
279,213.48
$
92,393.31
$
620,165.85
$
1,469,217.00
$
287,506.65
$
DERP DHMP
-
$
53,155.25
$
18,272.40
$
71,427.65
$
216,778.00
$
136,173.95
$
DERP HDHP
514,880.56
$
12,219.59
$
45,923.21
$
573,023.36
$
119,997.00
$
219,699.61
$
DPPA DHMO
-
$
5,658.24
$
2,803.65
$
8,461.89
$
58,982.00
$
2,804.57
$
DPPA HDHP
-
$
24,725.37
$
5,660.25
$
30,385.62
$
109,848.00
$
9,570.60
$
Total
1,063,082.36
$
614,529.65
$
263,066.69
$
1,940,678.70
$
3,769,177.00
$
1,059,687.43
$
5
Rx excludes PBM administrative costs
4
Medical Professional is defined as all paid 1500 claims
Paid Claim Summary
1
1
Medical and Rx claims are based on date paid
2
Medical Inpatient is defined as paid facility claims with a bill class code of 1 & 2 and all facility codes except 7 & 8
3
Medical Outpatient is defined as all other facility claims
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Org Policy
Relationship
Member Total
Primary DX Code
DERP ELEVATE HDHP
Subscriber
$225,969.49 C17.0
CSA ELEVATE HDHP
Subscriber
$187,871.61 I21.3
CSA ELEVATE HMO
Subscriber
$165,396.95 M51.17
CSA ELEVATE HMO
Subscriber
$125,642.97 E13.10
1
High-cost defined as $100K+ total for year
High Cost Claim Summary 2022
1
Insurer
Diagnosis
Denver Health Plan Inc.
Malignant neoplasm of
duodenum
Denver Health Plan Inc.
Other specified diabetes
Denver Health Plan Inc.
ST elevation (STEMI)
Denver Health Plan Inc.
Intervertebral disc disorders
Service Year 2020
Service Year 2021
CSA DHMO
(2,501.05)
$
15,807.28
$
CSA HDHP
(969.72)
$
51,272.25
$
DERP DHMO
632.40
$
2,548.38
$
DERP HDHP
(1,060.09)
$
332,274.66
$
DPPA HDHP
-
$
1,995.26
$
Total
(3,898.46)
$
403,897.83
$
Claim Run-Out Summary - Paid Year 2022
B.
Health Employer Data Information Set, National
Center for Quality Assurance standards will be used
to define the Performance Standards above.
Response:
Beginning with 2020 per mutual agreement, the
HEDIS reporting and performance guarantees were
retired.
1.4
The Authority - City Employee Healthcare
Opinion Survey.
A.
The Authority and the City agree that the
Authority’s Marketing and Public Relations
Department will coordinate with the City’s Executive
Director of the Office of Human Resources to conduct
a Denver City Employee Healthcare Opinion Survey
(“Survey”).
B.
The Survey may be conducted periodically but
no more than every two years with the next survey
scheduled for 2023.
Denver Health will provide a copy
of the Survey to the City’s Executive Director of the
Office of Human Resources.
The Executive Director
has the right to review and approve the timing of
publication and content design of the Survey prior
to publication for coordination with other employee
surveys.
C.
Once the Survey is pre-approved by the Executive
Director of the Office of Human Resources, the
Authority will provide a link to the Survey for
publication in the City’s Employee Bulletin or, if
the Bulletin is no longer available, within the City’s
regular electronic employee communication.
The
survey link will be made available to employees for
up to two consecutive weeks.
D.
The Survey content shall be designed and
prepared by Denver Health at Denver Health’s sole
cost and expense.
The survey will be conducted and
programmed by a market research organization
selected and paid for by the Authority.
The
Survey results shall be considered proprietary and
confidential to the Authority.
The Authority will share
an executive summary of the Survey results with the
City upon request.
Response:
Beginning with 2020, per mutual agreement the
CAHPS reporting and performance guarantees were
retired.
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10
A-8
Rocky
Mountain Poison
and Drug Safety
Services
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Appendix A-8 Rocky Mountain Poison and
Drug Safety Services
1.4
Performance Criteria
A.
Telephone lines will be answered within six rings.
The Poison Center will answer phones 24 hours a day,
365 days a year.
Response: Criteria met
Telephone lines were answered within five rings.
The
Rocky Mountain Poison and Drug Safety (RMPDS)
provides information to health care professionals
and the public 24 hours a day, 365 days a year.
B.
Physicians will respond to complicated, difficult or
unusual cases within 10 minutes of page.
Response:
Criteria met
C.
The Center will maintain certification by the
American Association of Poison Control Centers.
Response:
Criteria met
RMPDS was re-certified in 2017 by the American
Association of Poison Control Centers. The current
certification is effective through 2022.
D.
The Center will provide public education in the
Denver Metro Area.
Response: Criteria met
In 2022, RMPDS distributed 2,480 pieces of public
education materials on poison prevention for human
and animals, in both Spanish and English, in the
Denver Metro area. RMPDS maintains the Colorado
Poison Center website
(www.copoisoncenter.org)
,
that offers one-click contacting for individuals who
may prefer non-telephonic routes of correspondence
(i.e. chatting, email, texting).
Call Volume
2020
2021
2022
Trend
Poison Center
1
Denver
5,218
4,379
4,509
State
35,482
33,032
37,204
Drug Consultation Center
2,3
Denver
188
169
78
State
61,129
47,244
34,737
1 Includes poison center calls and public health emergency service calls
2 State totals combine Denver County, Colorado and out-of-state calls and
electronic inquiries
3 Client base changes annually
Call Volume Trends Analysis:
In 2022, the total Denver & Colorado calls to the
Poison Center got closer to approaching pre-COVID
volumes.
Suicide gestures/attempts by drug overdose in
Denver City and County reported to the Poison
Center have increased slightly (1%) from 2021 to
2022. There were 2 deaths in 2022 which is an 80%
decrease from 2021 (10 reported) and 78% decrease
from 2021 (9 reported) and more closely aligning
with 2019 pre-pandemic patterns (3 deaths reported
Public Information Materials
2020
2021
2022
Trend
Pieces Distributed
1,325
1,000
2,480
15
19
12
0
5
10
15
20
25
30
35
40
45
50
2020
2021
2022
Seconds
Average Speed
to Answer
Goal
(45 seconds)
Good
F.
The Authority will provide an annual report by May
1 of the year following the year being reported on,
which includes the following information for the year
just ended and the previous Fiscal Year:
Number of calls from Denver County and total State
calls for:
Poison Center
Drug Consultation Center
Response:
Criteria met
See table below for details.
E.
The Rocky Mountain Drug Safety Services Center
will answer telephone calls within six rings during
working hours 8:00 a.m. to 4:30 p.m., Mountain Time.
Response:
Criteria met
RMPDS answers telephone calls within six rings and
is staffed 24 hours per day, 365 days per year.
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in 2019).
Case severity in 2022 mimicked 2021 (77
cases with major [life-threatening] outcome; 76,
respectively). Cases marked with a “moderate”
medical outcome increased by 12% (422 reported
in 2022, 377 reported in 2021).
Straightforward
cases marked with a “minor medical outcome” or
“no effect” increased by 5.3% over the prior year
(3138 total in 2022, and 2980 reported in 2021).
This
supports the hypothesis that when the poison center
is involved in the medical management of a poisoned
patient, patient outcomes are optimized (resulting in
more cases of minor or no effect, less cases of major
outcomes or death).
By supporting poison center
efforts, we can hopefully improve patient outcomes
when it comes to the poisoned patient, especially
in the setting of complicated or serious exposures.
In summary, overall Poison Center case volume
in Denver City and County increased from 2021 to
2022.
Exposures involving suicide gesture rose 1%,
but exposures resulting in deaths were significantly
decreased by 80% from the prior year.
We hope to
see this reduced fatality pattern continue, and our
efforts in reducing serious outcomes in the poisoned
patient will remain a top priority.
In 2022, we continued to meet the preferences of the
community by supporting an omni-channel platform
(webchat, text-to-chat, and email).
Implemented
in 2021 and continued in 2022, we followed up calls
to the Poison Center hotline with an outbound text
message containing case reference number and
Drug Consultation Center Program (A-8 Program)
1Q2022
2Q2022
3Q2022
4Q2022
2022 Total
2021 Total
2020 Total
Denver Drug Consultation Line Case Volume
16
16
17
15
64
169
188
All Other Drug Center Client Case Volume
11,864
8,813
7,308
6,432
34,417
47,244
61,129
Total Drug Center Cases
11,880
8,829
7,325
6,447
34,481
47,413
61,317
Other RMPDS Services Benefitting Denver Residents
Poison Center
1
Cases from Denver county (answering calls 24/7/365 within 6 rings
2
)
1,131
1,158
1,082
1,138
4,509
4,379
5,218
All other Medical Triage Cases (DH Patients who live in the City)
0
0
0
0
0
0
0
Poison Center
1
Cases from All Others (only Colorado calls)
7,971
8,531
7,995
8,252
32,749
33,032
35,482
Poison Center
1
Public Education Pieces (English or Spanish) Distributed to Denver County
1,350
500
630
0
2,480
1,000
1,325
A-8 Program Contact Center Full-Time Equivalents
Hours of Operation - Answering Calls 24/7/365
744
2,184
2,208
2,208
7,344
8,784
8,784
FTE Equivalents (assumes 1,828 work hours per FTE per year; 25% FTE coverage)
0.30
0.30
0.30
0.30
1.20
1.20
1.20
A-8 Program Expenses
Actual Average Drug Center FTE Staff Salary Cost Plus Benefits
160,493
$
160,493
$
160,493
$
160,493
$
641,971
$
641,972
$
116,157
$
Staff Cost Based on Hours of Operation & Staffing Coverage
120,369
$
120,369
$
120,369
$
120,369
$
481,476
$
160,493
$
139,388
$
Telephone Line Cost (for 303-389-1112)
585
$
585
$
585
$
585
$
2,340
$
780
$
780
$
DrugDex Software License
2,400
$
2,400
$
2,400
$
2,400
$
9,600
$
3,200
$
3,200
$
Total Drug Consultation Program Cost
123,354
$
123,354
$
123,354
$
123,354
$
493,416
$
164,473
$
143,370
$
Collected Revenue Per the City Operating Agreement
72,675
$
72,675
$
72,675
$
72,675
$
290,700
$
96,900
$
96,900
$
Variance (Discounted Amount)
(50,679)
$
(50,679)
$
(50,679)
$
(50,679)
$
(202,716)
$
(67,573)
$
(46,470)
$
% Variance (Discount)
41%
41%
41%
41%
41%
41%
32%
2022 Quarterly Denver Health Rocky Mountain Poison and Drug Safety Services (A-8)
Providing Drug Consultation Services for the City and County of Denver
1
Poison Center is certified by American Association of Poison Control Centers through 2022
2
Poison Center physician escalations occur within 10 minutes
contact information should caller need help again.
In 2022, the Poison Center sent (SMS) as a follow-
up.
These outbound messages improved the caller
experience by making it easy and convenient for
the caller to follow-up while minimizing time Poison
Center staff needed to manually search for cases.
Drug Consultation Center total volumes for Denver
have slightly decreased over the last year; due
to promoting the service to both NurseLine and
Poison Center for inquiries related to safe use of
pharmaceuticals.
Additional volumes can be realized
by promoting the phone line to city agencies that
frequently get such request for information and
RMPDS would like to further that during 2022 in
conjunction with DDPHE.
G.
The Authority will provide a quarterly report to the
City in the format attached to this Appendix, which
indicates the amount of year-to-date expenses and
revenues for RMPDS by the forty-fifth (45th) day after
the end of the reporting period.
Response:
Criteria met
See table below for details.
H.
Requests for consultation services to City and
County of Denver regulatory agencies will be
responded to within 48 business hours.
Response:
Criteria met
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11
A-9 Clinical
and Laboratory
Services for
the City's
Department of
Public Health &
Environment
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Appendix A-9 Clinical and Laboratory
Services for the City’s Department
Environmental Health.
1.4
Specific Time Frame for Performance;
Performance Criteria and Laboratory
Report Delivery.
Clinical and Laboratory Services for the City are a
Core Service as defined in the Operating Agreement.
A.
The Authority’s Department of Pathology and
Laboratory Services (DPLS) shall provide service
24-hours per day, seven days per week.
DPLS agrees
to render Laboratory Services for the patients of
the City in accordance with orders given by the
physicians treating the patient.
Response:
Criteria met
DPLS provided all laboratory services 24 hours per
day, seven days per week, and in accordance with
orders given by the physicians treating the patient.
B.
DPLS shall use reasonable efforts to complete
tests within stated expected turnaround times (TAT)
following receipt of the specimen and the requisition.
In general, TAT should be no more than four (4) days
following receipt of the specimen and the requisition,
unless the test is esoteric, anatomic pathology,
molecular diagnostic testing, or a microbiology test
which requires longer turnaround. DPLS pricing and
TAT for 2022 has been distributed and accepted by
the City.
Response:
Criteria met
99%
of all test results were resulted (reported) within
their established turnaround times as stated by the
laboratory. All turnaround times were met within 24-
72 hours except for specialized tests performed at
DPLS or tests that were sent to reference laboratories
(as noted above).
C.
Routine Histology slides shall be available within
five (5) business days following specimen receipt by
DPLS.
Response:
Criteria met
Turnaround times were met for 99% of routine
histology slides being available within 5 days.
D.
DPLS agrees to deliver a copy of the laboratory
report in a timely manner and per the hospital
laboratory TATs.
The laboratory test report will
include at a minimum: patient's name, date of test,
test name, test result, normal values, laboratory
name and address.
DPLS agrees to make all records
on the City patients to whom DPLS has rendered
services available for the City upon request.
Response:
Criteria met
Copies of laboratory reports were provided upon
request according to the specifications noted and in
a timely manner.
E.
The City shall notify DPLS of any time-sensitive
testing requirements. On request for time-sensitive
laboratory testing, the Authority shall meet the time
requirements of the City whenever possible.
Response:
Criteria met
There were no incidents in which DPLS was notified
of time-sensitive testing requirements by the Office
of the Medical Examiner or another affected City
agency.
F.
If the laboratory is unable to run a requested test
within the TAT specified, it shall immediately notify
the Office of Medical Examiner or other affected City
agency.
Response:
Criteria met
There were no incidents in which DPLS needed to
notify the Office of the Medical Examiner or another
affected City agency of any situations where TATs
could not be met.
G.
All concerns or complaints regarding laboratory
services shall be directed to the Director of DPLS.
Response:
Criteria met
The Director of DPLS was not notified by the office
of the Medical Examiner or another affected City
agency of any concerns or complaints during 2022.
H.
The laboratory code of ethical behavior ensures
that all testing performed by the laboratory are billed
only for services provided. All marketing and billing is
performed in accordance with community standards;
all billing is for usual and customary services. All
business, financial, professional, and teaching
aspects of the laboratory are governed by standards
and professional ethics.
Response:
Criteria met
There were no changes to pricing in 2022. Pricing
is available in the laboratory services fee schedule
which is available upon request. Fees are created
using CMS reimbursement rates and are reviewed
annual for changes.
12
B-1 Center for
Occupational
Safety and
Health (COSH)
and Worker's
Compensation
Triage Line
(OUCH Line)
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62
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Appendix B-1 Center for Occupational
Safety and Health (COSH) and Worker’s
Compensation Triage Line (OUCH Line)
1.6
Reporting
A.
Annual Report. The Authority will provide an
annual report by May 1 of the year following the
year being reported on, which includes performance
statistics for the year just ended and the two
previous fiscal years relating to the services provided
to the City under this Appendix B-1.
The report shall
include, but not be limited, the following items for
City employees:
Workers’ Compensation Encounters:
Initial visits
Follow-up visits
Emergency room visits
Number of referrals
Response:
Criteria met
See table below for details.
Center for Occupational Safety & Health
(City Only)
2020
2021
2022
Trend
Workers’ Compensation Encounters
3,732
3,913
3,683
Initial Visits (new workers’ comp cases)
733
621
613
Follow-up Visits (workers’ comp)
2,400
2,387
2,303
Emergency Room Visits (CSA only)
258
122
168
Referrals
1,116
1,293
1,210
Worker's Compensation Encounters:
Average time from initial treatment to
maximum medical improvement (MMI)
Response:
Criteria met
See table for details.
2020
2021
2022
Trend
Average
80
61
147
Median
80
61
147
Average
38
35
89
Median
24
25
60
Average
31
36
61
Median
17
5
29
Average
63
54
59
Median
43
36
26
Average
47
17
35
Median
4
12
22
Average
6
N/A
7
Median
6
N/A
7
Average
43
4
113
Median
30
4
94
Average
87
54
84
Median
69
30
91
Average
14
10
15
Median
5
3
8
Average
57
9
17
Median
57
5
18
Average
26
42
18
Median
14
15
8
Average
34
51
34
Median
36
37
16
Average
87
8
N/A
Median
4
8
N/A
Average
9
N/A
N/A
Median
9
N/A
N/A
Average
124
N/A
N/A
Median
124
N/A
N/A
Average
87
90
131
Median
71
74
129
Average
37
32
31
Median
8
15
13
Average
46
31
27
Median
10
13
11
Average
N/A
2
N/A
Median
N/A
2
N/A
Average
41
78
51
Median
41
78
29
Average
N/A
N/A
4
Median
N/A
N/A
4
Average
64
75
74
Median
28
37
65
Average
47
22
25
Median
12
9
19
Jaw
(Reported in Days)
Hand
Head
Heart
Hip
Knee
Groin
Chest
Chin
Ear
Back
Body Part
Abdomen
Ankle
Arm
Forearm
Forehead
Genitals
Leg
Elbow
Eye
Face
Finger
Foot
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2020
2021
2022
Trend
(Reported in Days)
Body Part
Average
3
13
29
Median
3
13
29
Average
N/A
N/A
3
Median
N/A
N/A
3
Average
94
45
0
Median
68
45
0
Average
N/A
N/A
N/A
Median
N/A
N/A
N/A
Average
60
28
59
Median
44
8
27
Average
40
85
99
Median
40
86
52
Average
6
4
75
Median
6
4
75
Average
12
15
7
Median
12
15
124
Average
40
92
124
Median
27
86
129
Average
N/A
N/A
38
Median
N/A
N/A
3
Average
N/A
15
3
Median
N/A
15
3
Average
N/A
N/A
117
Median
N/A
N/A
117
Average
84
29
11
Median
83
9
6
Average
20
47
251
Median
20
47
251
Average
57
87
28
Median
29
63
30
48
39
57
27
15
27
Lumbar
Teeth
Total MMI median days
Rib
Shoulder
Throat
Thigh
Thumb
Toe
Mouth
Multiple
Wrist
Total MMI averaged days
Nose
Neck
Lung
Lip
Non-Workers’ Compensation Encounters:
By Agency or Department as identified below.
Response:
Criteria met
See table below for details.
Other services:
As requested in the prior contract year.
Response:
Criteria met
Other services were not requested in 2022.
B.
Performance Criteria Review:
As part of the
medical management process identified in section
1.4 of this Appendix, the COSH, on an ongoing
basis, shall conduct a performance criteria review
of the services provided by a consultant specialist
as indicated in his/her file for each City employee
Agency
2020
2021
2022
Trend
Animal Control
0
1
32
Art Museum
0
0
0
Arts and Venues
5
0
1
Civil Service Commission
1
289
572
Clerks and Recorder
202
2
13
Community Planning
0
2
0
Department of Finance
0
0
0
Department of Safety
34
1
75
Denver International Airport
11
2
1
Environmental Health
14
1
4
Excise & License
0
0
0
Fire Department
39
46
62
General Services
6
1
1
Human Services
0
1
43
Marshal Division
0
0
0
Parks and Recreation
155
214
138
Police Department
115
120
104
Public Library
44
30
34
Public Works
668
561
417
Sheriff's Department
244
221
238
Social Services
0
0
1
Tech Services
1
0
0
TOTAL
1,539
1,492
1,736
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for whom the physician has an open file based
on an COSH referral.
The COSH shall provide the
completed reviews, including all raw data, to the
Risk Management office quarterly at the end of
the quarter in which the review was performed.
In
addition, the Authority and City will jointly identify
and expand the performance statistics measured
and provided by the clinic for work related injuries to
identify areas of improvement.
Response:
Criteria met
The COSH Medical Director and City Case Manager
discuss performance regularly as part of their
monthly meeting.
C.
Other Requested Reports:
COSH shall provide
mutually agreed upon reports as requested by
Risk Management office to quantify services and
workloads, performance metrics, and identify
achievement of best practices.
Response:
Criteria met
Other reports were not requested in 2022.
13
B-2 NurseLine
Services
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Appendix B-2 NurseLine Services
1.3
Performance Criteria
A.
The NurseLine will respond to callers 24 hours a
day, 365 days a year.
Response:
Criteria met
B.
Call Center Agents will intake calls, gather chief
complaint or medical question, and will collect
demographics on calls where medical information is
provided.
Response:
Criteria met
C.
Registered Nurses will provide medical triage
utilizing National Guidelines to arrive at a final
disposition of 911, ED, Urgent Care, Appointment, or
Home Care.
Response:
Criteria met
D.
Calls resulting in a recommendation for medical
care within 24 hours may be provided second level
triage by an experienced medical provider. All
medical providers will be overseen and trained on
DHNL procedures by a Board Certified Emergency
Medicine Physician. Trained professionals will
respond to the caller with medical information,
provide instructions for home care, or recommend
that the caller seek care at a medical facility.
Response:
Criteria met
E.
Language Translation will be provided for callers
through Denver Health medical interpretation
services or appropriate external medical language
interpretation services.
Response:
Criteria met
F.
The NurseLine will strive to adhere to call
center standards set by the Utilization Review
Accreditation Commission (URAC) Healthcare call
Center Guidelines, National Committee for Quality
Assurance Guidelines (NCQA), and the Health
Insurance Portability and Accountability Act (HIPAA).
Response:
Criteria met
G.
The Authority will provide a monthly report
to the City through the Executive Director of the
Department of Public Health and Environment. The
report shall provide numbers for the total and for
the target populations served that month and the
amount of year-to-date expenses and revenues for
the Denver Health NurseLine. The monthly report
shall be submitted to the City by the 20
th
day after
the end of each month.
Response:
Criteria met
H.
In addition to monthly reports described below,
the Authority will provide an annual report by May
1 of the year following the year being reported on
to the City through the Executive Director of the
Department of Public Health and Environment.
The
report shall include the following information for
the year just ended and the previous fiscal year:
NurseLine medical triage cases in total; medical
triage cases for uninsured, medically indigent
patients from the City and County of Denver;
physician medical triage cases; behavior health
cases; all other cases; and medical interpretation
cases.
Response:
Criteria met
See table on the next page for details.
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City Program Case Volumes
2020
2021
2022 Trend
Uninsured Citizen Medical Triage Cases (non-DH patients)
3,403
2,327
1,752
Uninsured Citizen Behavioral Health Cases (non-DH patients)
36
23
20
Citizen Medical Triage Cases (non-DH patients, insured)
20,054
17,640
7,419
Behavioral Health Cases (non-DH patients, insured)
186
159
99
Referral Cases (offer resources in the City, non-DH patients)
1,255
703
326
Totals
24,934
20,852
9,616
Percent of all calls from Uninsured Denver Citizens
14%
11%
18%
City Physician Medical Triage Cases (non-DH patients)
3,511
2,414
815
All other Medical Triage Cases (DH patients who live in the City)
45,102
37,537
40,280
Medical Interpretation (minutes; non-DH patients)
19,908
12,624
9,217
Estimated Total Cost of Program
766,635
$
628,885
$
308,147
$
Total Cost to the City for Uninsured*
60,000
$
60,000
$
60,000
$
*This is a flat fee service contract for $60,000 each year as per the agreement
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14
B-3
Acute and
Chronic Health
Care at Denver
County Jail
and Downtown
Detention Center
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Appendix B-3 Acute and Chronic Health
Care at Denver County Jail and Downtown
Detention Center
1.7
Reporting Requirements:
The Authority shall continue to provide the following
reports unless modified by written agreement of the
parties in the Utilization Management (UM) process:
A.
Reports and meetings as required by the National
Commission on Correctional Health Care (NCCHC),
the American Correctional Association (ACA), and to
meet Prison Rape Elimination Act (PREA) standards;
Response:
Criteria met
In accordance with the Jail's NCCHC and ACA
accreditation, Denver Health works collaboratively
with the Denver Sheriff's office to coordinate reports
and meetings. UM is managed by CCMF and Erin
Ellquist is the point of contact. Denver Sheriff Health
Services is NCCHA and ACA Accredited.
All other
reports have been submitted as requested.
B.
Sheriff’s Department Monthly Statistical Report on
Health Services Activities;
Response:
Criteria met
C.
Any meetings as deemed necessary by the Sheriff
or designee the Health and Hospital Authority.
Response:
Criteria met
D.
Schedule of health care personnel and specific
jail assignments of specific days upon request by the
Sheriff or designee.
Response:
Criteria met
In 2022, schedule data was not requested but was
available upon request.
15
B-7 Miscellaneous
Services for DDPHE
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Appendix B-7 Miscellaneous Services for
DDPHE
1.1
Agreement to provide additional
miscellaneous services
A.
Occasionally during the year, the City requires
and the Authority agrees to provide additional
services, including materials, not specified in this
Agreement. The Authority will provide reasonable
medical services to the City upon request.
Response:
Criteria met
In 2022, the Authority provided additional services
when requested by the City.
1.2
Park Hill
The Authority has operated a family health center in
the Park Hill neighborhood for many years.
In order
to assist the Authority in carrying out its mission, the
City has committed to partially fund land acquisition,
construction and equipping of the Park Hill clinic.
a.
Pursuant to an Agreement (the Funding
Agreement), the City has agreed to partially fund
land acquisition and construction of the Park Hill
Clinic. The City’s maximum payment obligation for
the land acquisition and construction of the Park
Hill Clinic over the term of the Funding Agreement
will not exceed $4.788 million. The City’s annual
contribution is subject to appropriation by City
Council and is calculated in accordance with the
formula contained in the Funding Agreement.
For
Fiscal Year 2022, the City’s annual payment for its
land acquisition and construction contribution to the
Park Hill Clinic shall be $173,500.
Response:
Criteria met
Denver Health validates this number annually
with the City and the invoicing process is updated
accordingly.
1.3
South Westside Clinic ("Federico Pena
Family Center)
The Authority constructed the Southwest Family
Health Center (formerly referred to as South
Westside Clinic and South West Clinic) to serve
the west Denver population. In order to assist
the Authority in carrying out its mission, the City
has committed to partially fund the construction
improvements through proceeds of the Better
Denver Bonds program (the "South Westside Clinic
Proceeds") and the Capital Improvement Fund
(CIF), pursuant to the terms of the Southwest Family
Health Center Funding Agreement.
a.
From 2017 and continuing through 2028, the City
will pay an amount not to exceed $1,200,000.00 each
year. The City's total funding for the clinic from all
sources for all time shall not exceed $22,150,00.00.
b.
The City's obligation to make this payment is
pursuant to the terms of the South Westside Clinic
Funding Agreement and shall be contingent upon:
such funds being appropriated and paid into the
City Treasury and encumbered for the purposes
of this Agreement on an annual basis by the City;
compliance with this Agreement; the completion
of the funding agreement referred to above; and
compliance with the same funding agreement.
Response: Criteria met
Denver Health provided the annual final
reconciliation due on 3/31/2023.
1.4
Office of the Medical Examiner (OME)
Services
Denver Health will provide instrument sharpening
for no charge utilizing the full-time onsite vendor.
OME will need to either deliver the instruments to the
main campus or arrange for transport via the Denver
Health Courier. Biomedical waste, pathological waste,
and sharps will be disposed of utilizing the vendor
contracted to provide services to Denver Health.
The DH Safety Department will arrange for the
vendor to pick this waste up directly from the OME in
coordination with the OME. The cost will be $.19 per
pound for bio-hazardous waste and sharps and $.85
per pound for pathological waste or any other items
requiring incineration. DH will receive and process
the invoices for these services and bill the charges to
the OME.
Response:
Criteria met
See table below for details.
Office of Medical Examiner - Waste Removal
2020
2021
2022
Trend
Biomedical and Sharps
11,821
14,390
13,346
Pathological and Chemo (incineration required)
621
565
681
Total
12,442
14,955
14,027
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1.5 Treatment on Demand
To promote the goals of rapid access to substance use treatment, linkage to community based substance use
treatment, and recovery, Outpatient Behavioral Health Services (OBHS) will report the following performance
and outcome metrics on a monthly or annual basis according to the agreed-upon templates:
A.
Treatment on Demand Access Measures
i.
Number of persons with a substance use disorder seen by treatment on demand
ii.
Number of persons receiving bio-psycho-social evaluation
iii.
Number of persons receiving medication-assisted treatment (MAT) induction
iv.
Number of persons linked to community-based care within 48-hours
v.
Percentage retained in treatment >90-days and beyond
vi.
Assess for increase in capacity at local OTP providers
Response:
Criteria met
See table below for details.
Treatment on Demand Access Measures
2020
2021
2022
Number of Persons with a Substance Use Disorder
Seen by Treatment on Demand
799
471
795
Number of Persons Receiving Bio-Psycho-Social
Evaluation
617
413
496
Number of Persons Receiving MAT Induction
590
378
448
Number of Persons Linked to Community-Based
Care within 48 Hours
362
179
178
Percentage Retained in Treatment >90 Days and
Beyond
31% (192 retained 90 days / 539
Biopsychosocial Evaluations Completed
Jan-Oct 2020)
38% (86 retained 90 days / 227
Biopsychosocial Evaluations Completed
Jan-Oct 2021)
56% (277 retained 90 days
1
/ 496
Biopsychosocial Evaluations
Completed)
Assess for Increase in Capacity at Local OTP
Providers
13 patients were referred to partner
OTPs
8 patients were referred to partner
OTPs
7 patients were referred to partner OTPs
1
Dec 90-day retention not yet available
Treatment on Demand Access Measures
2020
2021
2022
Evaluate and Report Linkage and Retention in
Treatment for Persons Referred External to the DHHA
System and for Patients within the DHHA System
1
Internal DHHA linkage and retention
data has been reported on a monthly
basis and is included above. For
external partners, 13 patients were
referred out and 8 successfully linked.
Internal DHHA linkage and retention
data has been reported on a monthly
basis and is included above. For
external partners, 8 patients were
referred out 4 successfully linked.
Internal DHHA linkage and retention
data has been reported on a monthly
basis and is included above. 39 patients
were referred to external partners
(across all substances). External
partners are not currently able to share
linkage and retention data.
Monitor the Opioid Continuum Cascade
We continue to do this, the data above
shows number of patients identified,
linked, and retained (which are the
major components of the cascade).
We continue to do this, the data above
shows number of patients identified,
linked, and retained (which are the
major components of the cascade).
We continue to do this, the data above
shows number of patients identified,
linked, and retained (which are the
major components of the cascade)
Assess Treatment on Demand Services Outlined in a.i-
v (above) by Number of Persons with an OUD,
Stimulant Use Disorder (SUD), or Alcohol Use Disorder
(AUD)
2
The Treatment on Demand 2020 Metrics
Spreadsheet is available upon request
and provides the metrics by substance
for the full year.
The Treatment on Demand 2021 Metrics
Spreadsheet is available upon request
and provides the metrics by substance
for the full year.
The Treatment on Demand 2022 Metrics
Spreadsheet is available upon request
and provides the metrics by substance
for the full year (with the exception of
the Q4 retention data which is not ready
by the time reporting occurs).
1
External partners do not have a comparable EHR making it difficult to share retention data with DH TOD
2
Nov/Dec 90-day retetention not available yet
B.
Develop and report metrics to:
i.
Evaluate and report linkage and retention in treatment for persons referred external to the DHHA
system and for patients within the DHHA system
ii.
Monitor the opioid continuum cascade
iii.
Assess treatment on demand services outlined in a.i-v (above) by number of persons with an opioid-use
disorder (OUD), stimulant use disorder (SUD), or alcohol use disorder (AUD)
Response:
Criteria met
See table below for details.
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16
B-8
Miscellaneous
Services
for the
Department of
Public Safety
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Appendix B-8
Miscellaneous Services for
the Department of Public Safety
1.1
Agreement to provide additional
miscellaneous services
A.
Occasionally during the year, the City requires
and the Authority agrees to provide additional
services, including materials, not specified in this
Agreement. The Authority will provide reasonable
medical services to the City upon request.
Response:
Criteria met
In 2022, the Authority provided additional services
when requested by the City.
1.2
Sexual Assault Nurse Examiner (SANE)
A.
In accordance with State statute C.R.S. 18-3-407.5
which requires that the law enforcement agency
referring a victim of sexual assault or requesting an
examination of a victim of sexual assault pay for any
direct cost associated with the collection of forensic
evidence from such victims, the City hereby agrees to
reimburse the Authority for the costs associated with
the collection of forensic evidence of sexual assault
victims, including photography services for cases of
domestic violence, non-accidental trauma or other
physical assaults, as requested or referred by a City
law enforcement agency at the following per exam
rates: $680.00 for victims and $235.00 for suspects,
which is the Authority’s actual cost. Forensic
photography for cases of domestic violence, non-
accidental trauma, or other physical assaults may
also be provided by the SANE per law enforcement
request and pending the availability of the examiner
for a fee of $175.00. This payment is characterized as
a fee for service.
B.
The City will purchase, prepare, and provide
the evidence kits to the Authority.
The completed
forensic evidence kit will be transported, using
proper chain of custody procedures, to the Police
Headquarters building.
C.
The City will reimburse the Authority a maximum
of $6,000 annually for the cost of registration and
travel expenses for the training of new SANE program
nurses. Requests for training must be submitted
for approval at least four weeks in advance for any
out-of-state travel and a minimum of two weeks in
advance for in-state travel.
An identified benefit to
the Denver Police Department SANE Program must
be included in the training request.
Reimbursement
for travel-related expenses will be subject to
Denver Police Department and/or General Services
Administration rates for reimbursement.
D.
Medical forensic examinations that do not
require evidence collection will have a rate of
$400.00 for victims. This would include sexual
assault examinations when a patient declines the
evidence collection portion, domestic violence, and
strangulation evaluations.
E.
The Authority’s SANE program nurses will collect
and preserve forensic evidence and document the
findings of victims of sexual assault.
The SANE
Program nurses will also conduct evidentiary exams
of suspects in sexual assault cases in accordance
with established protocol.
F.
The Authority will bill the Denver Police
Department on a monthly basis for exams.
The
invoice must contain all of the following information:
date of exam, delineation of victim/suspect, last
name and first name initial, medical record number,
encounter number, city/county designation, CAD
#, General Offense (GO) # and cost.
The Authority
agrees to provide this service without charge to the
victim.
G.
The Authority will be responsible for all training
and travel costs above the $6,000 annual cost for
new SANE program nurses reimbursed by the City.
H.
The Authority will present an annual accounting
of costs of the program by the end of January of the
following year. Requests for rate increases must be
submitted to the City at least sixty (60) days prior to
anticipated date of the rate increase and must be
accompanied by supporting documentation.
Response: Criteria met
Four quarterly reports were submitted within 45
days of the end of each reporting period.
Each
quarterly report provided a comprehensive summary
of activities occurring that quarter and expected
activities in the subsequent quarter.
Total Forensic Exams
2020
2021
2022
Trend
Victim Exams
407
359
411
Suspect Exams
1
3
6
Strangulation*
N/A
N/A
74
Total
408
362
491
*New metric in 2022 OA
1.3
Blood Alcohol Draws
The Authority will perform legal blood alcohol draws
for individuals brought to the Authority Emergency
Department by Denver law enforcement. The
Authority will follow chain of custody procedures
as set forth in Denver Health Policies and
Procedures P-2.040. The law enforcement officer
will take immediate possession of the specimen in
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accordance with the policy. The City will pay the
Authority $29.00 per specimen based on the monthly
invoice. This payment is characterized as a fee for
service.
Response:
Criteria met
See table below for details.
Blood Alcohol Draws
2020
2021
2022
Trend
Draws
577
524
246
1.4
At-risk Intervention and Mentoring (AIM
Program)
C.
The Authority’s AIM program will provide services
to over four hundred (400) unique individuals in
2022; an estimated 250 bedside interventions with
youth, one hundred and fifty (150) other community
individuals, and approximately twenty (20) critical
crisis interventions within the Authority and the
community.
Response: Criteria met
See table below for details.
AIM Program Services
2020
2021
2022
Result
Trend
Number of bedside interventions
2022 Goal: 250
247
424
353
Individuals served (unduplicated)
2022 Goal: 150
827
541
1083
Critical crisis interventions
2022 Goal: 20
60
40
45
D.
AIM will provide up to ten (10) trauma-informed
care trainings around at-risk youth to various
departments and staff members, including frontline
emergency department staff, community and school-
based clinic providers, and inpatient staff that
care for injured patients. Trainings will be 1-3 hour
blocks of interactive sessions with outreach workers,
molded to fit the needs of specific departments and
clinics; these activities will be eligible for continuing
education credits.
Response:
Criteria met
See table below for details.
F.
The Authority will present an annual accounting
of costs of the program by the end of January of the
following year. Requests for rate increases must be
submitted to the City at least sixty (60) days prior to
AIM Program Services
2020
2021
2022
Result
Trend
Trauma-informed care trainings
2022 Goal: 10
17
19
26
anticipated date of the rate increase and must be
accompanied by supporting documentation.
Response:
Criteria met
1.5 Heartsaver First Aid CPR AED Training
The Authority agrees to provide Heartsaver® First
Aid CPR AED – Adult, Child and Infant training by a
certified American Heart Association instructor(s) for
up to 100 of the students attending the Denver Fire
Department’s Young Adult Career Exploration Camp.
The course will prepare students to provide first aid,
CPR, and use an automated external defibrillator
(AED) in a safe, timely, and effective manner. Each
student who completes the course successfully will
be awarded a certificate or card which displays their
newly acquired First Aid certification. The City will
pay the Authority $45.00 per student enrolled in the
course. This payment is characterized as a fee for
service. Invoices shall include the date of training and
name of trainees.
Response:
Criteria met
Denver Health provides American Heart Association
CPR Training through Denver Fire Department's
Young Adult Career Exploration Camp which occurs
on an annual basis.
CRP AED Training
2020
2021
2022
Trend
Participants
0
52
32
TCC for Law Enforcement
2020
2021
2022
Trend
Classes
6
6
5
Participants
83
86
50
1.6
Tactical Casualty Care (TCC) for Law
Enforcement Training
The Authority agrees to provide Tactical Casualty
Care (TCC) for Law Enforcement training for all
Denver Police Department Recruits by instructors
who are minimally state certified EMTs, or preferably,
paramedics. The Authority will adhere to all POST
mandates for the training, including the instructor
ratio guidelines.
The City will pay the Authority
$95.00 per student enrolled in the course. This
payment is characterized as a fee for service.
Invoices shall include the date of training and name
of trainees.
Response:
Criteria met
Denver Health provides TCC for Law Enforcement
for all Denver Police Recruits annually as needed
through DPD's rotating academy schedule.
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1.7
Department of Safety Fit for Duty Psychiatric
Evaluations
A.
The Authority agrees to provide psychiatric
evaluations at the request of the City's Department
of Safety for the purpose of determining if a
Department of Safety employee is fit to return to
duty.
K.
The Authority will provide the City with medical
services in accordance with the terms and the
standard of care stated in the Operating Agreement.
Response:
Criteria met
The Authority provided psychiatric evaluations in
accordance with the terms stated in the Operating
Agreement.
See table below for details.
Performance Criteria
2020
2021
2022
# Psychological Fitness for Duty Exam
10
4
0
# Duty Exam appointments within 5 business days
10
4
6
# Full report transmissions with physician signature
10
4
6
# Psychological Testing Related to Fitness for Duty Exam
0
0
2
Total Invoiced Amount
$6,000
$2,400
$3,600
17
B-9 Miscellaneous
Services, Other
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Appendix B-9 Miscellaneous Services, Other
1.1
Agreement to provide additional
miscellaneous services
A.
Occasionally during the year, the City requires,
and the Authority agrees to provide additional
services, including materials, not specified in this
Agreement. The Authority will provide reasonable
medical services to the City upon request.
Response:
Criteria met
In 2022, the Authority provided additional services
when requested by the City.
1.2
Expert Witness
The Authority agrees to provide expert witnesses to
the City upon request for purposes of testifying in
court and or other formal hearings involving the City.
The City will reimburse the Authority up to the hourly
maximum of $150.00/hour for this service. The Denver
District Attorney’s Office will reimburse the Authority
up to an hourly maximum of $150.00/hour ($80/hour
for experts without advanced educational degrees
consistent with the Supreme Court Directive) for prep
time and expert witness testimony when the expert
is a prosecution witness testifying in state court
matters prosecuted by the Denver District Attorney’s
Office.
The witness must be qualified as an expert by
the Judge in open Court prior to providing testimony.
Each invoice shall include the following supporting
documentation: the dates of services, information
identifying the case, information identifying the
activity billed for, any off-setting revenue from the
City or other sources. This payment is characterized
as a fee for service.
Response: Criteria met
Denver Health provides Expert Witness support to
the city when requested.
1.3
Competency Examination
The Authority agrees to provide competency
evaluations or other investigative reports to
determine competency as requested by the County
Court. The Authority and the City’s County Court
have agreed to a new process, which includes
scheduling a two (2) hour time block of time for a
total of four (4) available examinations every week.
These examinations shall be performed for a per
report fee of $600.00. The City will pay the Authority
a $225.00 preparation fee for each individual who
fails to appear to the set examination. This payment
is characterized as a fee for service.
Response:
Criteria met
In 2022, Denver Health provided competency
evaluations as requested by the County Court and
invoiced the City for a total of $177,225 for court
competency evaluations.
Total Competency Exams
2020
2021
2022
Trend
# Completed
202
172
268
# Failures to Appear
112
86
73
Total Charges
145,275
$
122,550
$
177,225
$
18
Uncompensated
Care
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Total Denver Health Uncompensated
Care Cost (All Patients)
Uncompensated Care Cost for Denver
Residents Only
$-
$20,000,000
$40,000,000
$60,000,000
$80,000,000
$100,000,000
$120,000,000
2017
2018
2019
2020
2021
2022
Denver Health Medicaid, Medicare and Uninsured Uncompensated Care for Services
$ 38,183,761
$ 82,021,954
$ 120,205,715
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
18.0%
Front Range Hospitals Uninsured as a % of Total Care
Based on Total Charges by Payer Type (2021)
Source: HCPF 2023 Hospital Expenditure Report Detailed Data by Hospital: Total Gross Charges by Payer
https://hcpf.colorado.gov/sites/hcpf/files/2023HospitalExpenditureReport.pdf
Uninsured is defined as the total charges as reported by hospitals in Self Pay and CICP/Other payer categories
.
Denver Health 15.9%
Since becoming an Authority, Denver Health has been supported by an annual, fixed City Payment that offsets
a portion of the Total Uncompensated Care delivered each year. For 2022, 68% of the uncompensated care
population served identified a Denver County address.
The City's payment of $29.7 million covered 24.7% of
the $120.2 million in net cost (net of all other reimbursement) of total uncompensated care delivered by Denver
Health.
The most current data available from Colorado Department of Health Care Policy and Financing (HCPF) 2023
Hospital Expenditure Report shows that Denver Health's % of Total Care for Uninsured continues to be greater
than other Front Range hospitals.
19
Financial
Statements
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Denver Health and Hospital Authority
Statements of Net Position
December 31, 2022 and 2021
Assets and Deferred Outflows of Resources
2022
2021 *
Current Assets
Cash and cash e
q
uivalents
45,859,134
$
34,764,152
$
Patient accounts receivable, net of estimated uncollectibles
of a
pp
roximatel
y
$65,700,000 and $58,300,000
in 2022 and 2021, res
p
ectivel
y
101,222,178
85,793,299
Due from other
g
overnmental entities
42,728,580
39,338,502
Due from Cit
y
and Count
y
of Denver
5,699,020
10,566,148
Other receivables
7,534,963
14,646,851
Interest receivable
1,503,291
1,486,244
Due from other funds and investment in
discretel
y
p
resented com
p
onent units
10,821,071
7,312,026
Inventories
18,903,095
16,672,270
Pre
p
aid ex
p
enses and other assets
17,500,891
18,813,488
Total current assets
251,772,223
229,392,980
Noncurrent Assets
N
otes receivable
14,957,348
14,957,348
Estimated third-
p
art
y
p
a
y
or settlements receivable
3,865,767
5,339,026
E
q
uit
y
interest in
j
oint venture
586,958
1,269,500
Restricted investments
19,344,067
19,299,010
Ca
p
ital and leased assets, net of accumulated
de
p
reciation and amortization
640,640,976
684,175,767
Lon
g
-term investments
254,290,496
335,726,635
Board-desi
g
nated investments
1,800,001
10,200,000
Other lon
g
-term assets
10,735,024
12,026,115
Total noncurrent assets
946,220,637
1,082,993,401
Total assets
1,197,992,860
1,312,386,381
Deferred Outflows of Resources
Deferred outflows of resources related to
p
ension benefits
8,564,580
10,799,589
Deferred outflows of resources related
to other
p
ostem
p
lo
y
ment benefits
304,595
462,225
Loss on refundin
g
of deb
t
13,211,559
14,571,326
Total deferred outflows of resources
22,080,734
25,833,140
Total assets and deferred outflows of resources
1,220,073,594
$
1,338,219,521
$
* Restated for Implementation of GASB 87
SOURCE: Denver Health and Hospital Authority Audit Report, April 4, 2023. In order to accurately interpret
these statements, they should be read in conjunction with the notes that accompany the audited financial
statements, available upon request
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Denver Health and Hospital Authority
Statements of Net Position
December 31, 2022 and 2021
Liabilities, Deferred Inflows of Resources and Net Position
2022
2021 *
Current Liabilities
Current maturities of bonds
p
a
y
able
12,639,999
$
12,483,132
$
Current maturities of leases
4,196,919
4,198,584
Current maturities of notes
p
a
y
able
1,321,757
1,848,036
Medical mal
p
ractice liabilit
y
8,204,603
7,459,198
Accounts
p
a
y
able and accrued ex
p
enses
48,114,243
44,110,678
Accrued salaries, wa
g
es and em
p
lo
y
ee benefits
34,649,173
39,546,269
Accrued com
p
ensated absences
40,923,538
40,578,869
Accelerated Medicare
p
a
y
ments
-
12,881,163
Unearned revenue
35,385,137
26,731,582
Total current liabilities
185,435,369
189,837,511
Long-term Liabilities
Lon
g
-term
p
ortion of liabilit
y
for estimated third-
p
art
y
settlements
6,496,967
23,752,700
Lon
g
-term
p
ortion of com
p
ensated absences
116,077
116,076
Lon
g
-term
p
ortion of accelerated Medicare
p
a
y
ments
-
4,743,748
Bonds
p
a
y
able, less current maturities
270,031,630
283,110,305
Lease liabilit
y
, less current maturities
21,170,179
25,313,304
N
otes
p
a
y
able, less current maturities
44,349,512
41,843,417
N
et
p
ension liabilit
y
61,162,594
76,277,183
Postem
p
lo
y
ment benefits
3,337,059
4,147,787
Total lon
g
-term liabilities
406,664,018
459,304,520
Total liabilities
592,099,387
649,142,031
Deferred Inflows of Resources
Deferred inflows of resources related to
p
ension benefits
15,349,458
19,350,058
Deferred inflows of resources related
to other
p
ostem
p
lo
y
ment benefits
895,145
925,681
Deferred inflows of resources related to leases
6,660,121
7,092,501
Total deferred inflows of resources
22,904,724
27,368,240
Total liabilities and deferred inflows of resources
615,004,111
676,510,271
Net Position
N
et investment in ca
p
ital and leased assets
301,179,213
327,650,489
Unrestricted
303,890,270
334,058,761
Total net position
605,069,483
661,709,250
Total liabilities, deferred inflows of resources and net position
1,220,073,594
$
1,338,219,521
$
* Restated for Implementation of GASB 87
SOURCE: Denver Health and Hospital Authority Audit Report,
April 4, 2023
. In order to accurately interpret
these statements, they should be read in conjunction with the notes that accompany the audited financial
statements, available upon request
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Denver Health and Hospital Authority
Statements of Revenues, Expenses and Changes in Net Position
Years Ended December 31, 2022 and 2021
2022
2021 *
Operating Revenues
N
et patient service revenue
901,027,279
$
866,349,897
$
Capitation earned net of reinsurance expense
2,502,535
10,600,000
Medicaid disproportionate share and
other safety net reimbursemen
t
148,120,716
123,810,297
City and County of Denver payment for patient care services
29,700,000
27,700,002
Federal, state and other grants
99,509,389
87,345,995
City and County of Denver purchased services
30,007,576
27,158,245
Poison and drug center contracts
20,478,071
20,009,515
Other operating revenue
52,414,502
57,022,472
Total operating revenues
1,283,760,068
1,219,996,423
Operating Expenses
Salaries and benefits
773,970,366
746,896,687
Contracted services and nonmedical supplies
274,092,096
241,462,370
Medical supplies and pharmaceuticals
194,269,667
175,826,200
Depreciation and amortization
65,206,324
64,998,772
Total operating expenses
1,307,538,453
1,229,184,029
Operating loss
(
23,778,385
)
(
9,187,606
)
Nonoperating Revenues (Expenses)
Decrease in equity in joint venture
(
62,454
)
(
955,533
)
N
onoperating grant revenue (CARES Act/FEMA)
6,089,020
20,408,273
Interest income
10,197,601
15,570,917
Interest expense
(
14,011,163
)
(
13,890,717
)
Gain on dissolution of Southwest Clinic
-
4,982,853
N
et decrease in fair value of investments
(
36,563,351
)
(
7,016,141
)
Gain (loss) on disposition of capital assets
3,734
(
4,166
)
Total nonoperating revenues (expenses)
(
34,346,613
)
19,095,486
Income (loss) before capital contributions
(
58,124,998
)
9,907,880
Contributions Restricted for Capital Assets
1,485,231
4,388,096
Increase (decrease) in net position
(
56,639,767
)
14,295,976
Total Net Position, Beginning of Year
661,709,250
647,413,274
Total Net Position, End of Year
605,069,483
$
661,709,250
$
* Restated for Implementation of GASB 87
SOURCE: Denver Health and Hospital Authority Audit Report, April 4, 2023.
In order to accurately interpret
these statements, they should be read in conjunction with the notes that accompany the audited financial
statements, available upon request
20
Contract
Reconciliation
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April 12, 2023
To:
Faraz Khan, Chief Financial Officer, DHHA
From:
Meggan Parezo, Director of Shared Services & Business Operations, Denver Department of
Public Health & Environment
Subject:
2022 Denver Health Operating Agreement Contract Fiscal Close
Regarding the services outlined in the 2022 Operating Agreement provided by Denver Health and
Hospital Authority (DHHA) to the City and County of Denver, we agree that expenses for 2022 came in
under the initial forecasts outlined in the Operating Agreement. Any budget shortfall realized by a
specific section of the Operating Agreement was absorbed within the larger City appropriation it was
budgeted within. Therefore, 2022 is closed without the need for a contract budget amendment. Please
see Exhibit A for a breakdown of the variance by appendix.
Per recent audit recommendations, DHHA and the City agree that this memo and the Exhibit A will be
included in DHHA’s 2022 annual report to the City.
This memo concludes the Operating Agreement fiscal year 2022 close out. The City deeply appreciates
DHHA’s partnership in serving Denver’s most vulnerable populations, and your partnership in financial
management and reporting.
Meggan Parezo
Contracts & Grants Manager
Denver Department of Public Health and Environment
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Exhibit A: 2022 Operating Agreement Contract Budget Variance by Appendix
Appendix
Description
2022 Final
Approved Budget
2022 Type of
Payment
2022 Final
Difference
A-1
Medically Indigent Patient Care
29,700,000
Flat
29,700,000
0
A-2
Training: Continuing Education
547,033
Flat
547,033
0
A-2
Training: Certification
23,232
Fee for Service
23,308
-76
A-2
Englewood
1,217,922
Flat
1,217,922
0
A-2
DEN Paramedic
3,300,467
Actual
3,259,504.36
40,962.64
A-2
Medical Direction and QA/QI
for 911 Call Takers
109,238
Flat
109,238
0
A-2
Medical Direction Services
127,350
Flat
127,350
0
A-2
EMRS Oversight
90,038
Flat
90,038
0
A-2
Emergency Service Patrol
702,132.
Flat
702,132
0
A-3
Public Health
1,003,192
Actual
887,348.24
115,843.76
A-4
Denver C.A.R.E.S.
2,327,981
Actual
2,017,593.98
310,387.02
A-6
Legally Detained Care at
Hospital
4,475,000
Actual
4,655,861.01
-180,861.01
A-8
Rocky Mountain Poison Center
96,900
Flat
96,900
0
A-9
Clinical and Laboratory Services
25,000
Fee for Service
17,778.78
7,221.22
B-1
COSH and OUCH Line
625,000
Actual
463,163.20
161,836.80
B-2
NurseLine
102,797
Flat
102,797
0
B-3
Legally Detained Care at Jail
and Detention Center
16,761,817
Actual
17,028,146.73
-266,329.73
B-7
Parkhill Financing
273,500
Flat
268,551.32
4,948.68
B-7
South Westside Clinic CIP
Payment
1,200,000
Flat
1,200,000
0
B-7
Office of Medical Examiner
Waste Pick-Up
n/a
Fee for Service
3,932.33
n/a
B-7
OME Postage
n/a
Fee for Service
269.99
n/a
B-7
Treatment on Demand
404,247
Actual
404,247
0
B-8
Sexual Assault Nurse Examiner
(SANE)
188,000
Fee for Service
193,800
-5,800
B-8
Blood Alcohol Draws
8,000
Fee for Service
5,133
2,867
B-8
At-Risk Intervention and
Mentoring (AIM)
171,373
Flat
171,373
0
B-8
First Aid CPR AED Training
n/a
Fee for Service
0
n/a
B-8
Tactical Casualty Care for Law
Enforcement Training
n/a
Fee for Service
10,070
n/a
B-8
Fitness for Duty Psychiatric
Evaluations
n/a
Fee for Service
3,000
n/a
B-9
Expert Witnesses
40,000
Fee for Service
0
40,000
B-9
Court Competency Evaluations
185,000
Fee for Service
173,100
11,900
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DenverHealth.org